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Intraperitoneal Hydrocortisone Plus Bupivacaine Administration For Pain Relief After Laparoscopic Cholecystectomy

Author: 
Ashvin R Kankotiya and Adeesh P Jain
Subject Area: 
Health Sciences
Abstract: 

Background: Laparoscopic Cholecystectomy (LC) has become the gold standard for treatment of benign Gall Bladder disease. Laparoscopy provides many benefits over conventional open procedures including faster recovery time, shorter hospital stay, less pain, and in some cases, fewer complications. Post Operative pain management has an important role in preventing the postoperative morbidity and its consequences. This study is designed to evaluate the effect of intraperitoneal instillation of bupivacaine with hydrocortisone in comparison to bupivacaine alone for pain relief following laparoscopic Cholecystectomy. Aim and Objectives: To compare the effect of intraperitoneal instillation of bupivacaine with Hydrocortisone versus Bupivacaine alone for post-operative analgesia in laparoscopic Cholecystectomy. Methods: This study includes Laparoscopic Cholecystectomy conducted in the department of General Surgery at the Sir Sayajirao General Hospital & Medical College Baroda during a period of 12 months from January 2015 to December 2015. The patients were randomized into two groups by envelop method. Assessment of the pain was done & its intensity was recorded on VAS (visual Analogue scale) after 0hrs, 6hrs, 12hrs & 24hrs of surgery. Results: Total 50 patients were studied. Each group contain 25 patients. Bupivacaine with hydrocortisone instillation shows significant reduction in VAS Score at 6hr, 12 hr and 24hr (2.40, 3.28 and 4.00) as compare to bupivacaine alone (3.24, 4.28 and 5.04) and it is statistically significant as p value is <0.05 (0.0039,0.0026 and 0.0046) While reduction in VAS Score at o hr (1.08 and 1.48) is not statistically significant as p value is > 0.05 (0.3950). Conclusion: Intraperitoneal preoperative pre-emptive instillation of hydrocortisone with bupivacaine in laparoscopic Cholecystectomy significantly reduce post operative pain at 6 hr, 12 hr and 24hr but not at 0 hr, in comparison to bupivacaine alone.

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