Comparison of intraperitoneal and periportal bupivacaine and ropivacaine for postoperative pain relief in laparoscopic cholecystectomy: a randomized prospective study

Background: Patients experience considerable pain during the first 24 hours after laparoscopic surgeries in spite of great progress in pain relief methods. Intraperitoneal local anesthetics in different doses have been used effectively to reduce this pain. The present study was conducted to compare whether moderate dose (75 mg) intraperitoneal and peri-portal bupivacaine or ropivacaine can produce effective pain relief after laparoscopic cholecystectomy. Methodology: Eighty ASA I and II female patients undergoing laparoscopic cholecystectomy under general anesthesia were included in the study and were assigned to either of the two groups in a double blind randomized manner, Group B and Group R. At the end of the surgery, patients in Group B received 20 ml of 0.25% bupivacaine intraperitoneally and 10 ml was infiltrated in periportal area. Patients in Group R received 20 ml of inj. ropivacaine 0.25% intraperitoneally and 10 ml was infiltrated in periportal areas. Visual analogue score for pain and vital signs were recorded for 24 hours in the postoperative period. Injection of tramadol was administered as rescue analgesic. Total analgesic consumption in 24 hours and side effects were recorded. Results: Statistically significant difference (p< 0.05) was found in pain intensity (visceral and parietal pain) within groups during the first 4-6 hrs in the postoperative period. The total number of rescue analgesic doses were similar in both groups and statistically insignificant. Variables of post operative recovery were similar in both groups. Conclusion: Moderate dose intraperitoneal analgesia with local anesthetic (ropivacaine and bupivacaine) is simple to use and effective method with minimal side effects.