Effect of intra-abdominal spraying of ropivacaine on postoperative pain of laparoscopic cholecystectomy

Abstract

Objective To observe the effect of intra-abdominal local spraying of ropivacaine on postoperative pain of laparoscopic cholecystectomy(LC).Methods Eighty patients underwent elective laparoscopic cholecystectomy were randomly divided into four groups:experimental group Ⅰ:0.5％ ropivacaine 20 ml gallbladder bed injection after LC; experimental group Ⅱ:0.5％ ropivacaine 10 ml gallbladder bed injection and 10 ml diaphragm spray; control group Ⅰ:normal saline 20 ml gallbladder bed injection; control group Ⅱ:normal saline 10 ml gallbladder bed injection and 10 ml diaphragm spray.The abdominal pain at rest,shoulder pain,incision pain and pain when coughing were assessed by visual analog scale (VAS) at 1,4,8,24,48 hours after surgery in each group.Results The abdominal pain,incision pain and coughing pain scores of experimental group Ⅰ,Ⅱ were significantly less than the control group Ⅰ,Ⅱ at 1,4,8 hours after surgery (P ＜0.05) ; the shoulder pain score of experimental group Ⅱ was significantly less than the control group Ⅱ at each time after surgery (P ＜ 0.05) ; the shoulder pain score of experimental group Ⅰ was significantly higher than the experimental group Ⅱ at each time after surgery (P ＜ 0.05).Conclusions Gallbladder bed injection and diaphragm spray of 0.5 ％ ropivacaine 20 ml after laparoscopic cholecystectomy could relieve early abdominal pain,incision pain,shoulder pain,coughing pain and advanced shoulder pain effectively. Key words: Cholecystectomy; Laparoscopy; Ropivacaine; Analgesic