Use of combined wound and intraperitoneal ropivacaine instillation in laparoscopic cholecystectomy for postoperative pain management: A prospective randomized study at a referral center in Northeast India

Abstract

Background: Although laparoscopic cholecystectomy(LC) causes less postoperative pain than conventional laparotomy, still patients often suffer from considerable pain during early postoperative hours. In this study, efficacy of ropivacaine was studied in post-operative pain relief through peripheral local administration in patients undergoing LC. Aims and Objectives: The primary aim of the study is to evaluate the effect of intraperitoneal and local wound instillation of 0.75% Ropivacaine on post operative pain relief and duration of post-operative hospital stay in LC patients. Materials and Methods: This Prospective randomized Double blind clinical study was performed for 2 years on 190 patients. The primary endpoints of the study for the postoperative pain assessment were Visual Analog Scale (VAS) scores at 6 and 24 hours after LC and the amount of analgesics required in the postoperative period. These variables were compared between intervention and control groups. Results: The VAS score for pain abdomen in the intervention group (ropivacaine group) was significantly less, compared to the placebo group at 6 (P < 0.020) and 24 h (P < 0.001). Similarly, the mean of amount of analgesics used was much less in intervention group (46.5±13.2) than that in the placebo group (112.4±26.4). Conclusion: This study concludes that the combined intraperitoneal and local wound instillation of ropivacaine has a significant effect on the postoperative pain management in LC.