COMPARATIVE ASSESSMENT OF THE ANALGESIC EFFICACY OF INTERPERITONEAL BUPIVACAINE ALONE TO COMBINED BUPIVACAINE AND DEXAMETHASONE AFTER LAPAROSCOPIC CHOLECYSTECTOMY

Abstract

Background: Acute pain has been linked to laparoscopic cholecystectomy and various methods have been adopted to reduce postoperative pain after laparoscopy.
Aim: The present study aimed to comparatively assess the analgesic efficacy of bupivacaine  alone with combined bupivacaine and dexamethasone after laparoscopic cholecystectomy.
Methods: The study assessed 42 subjects who underwent laparoscopic cholecystectomy divided into two groups of 21 subjects each where Group I subjects, were given 40ml 0.25% bupivacaine and 16 mg dexamethasone and Group II subjects were given 40ml bupivacaine alone intraperitoneally. The time needed for the first analgesic, total rescue analgesic dose and VAS scores were compared between the two groups.
Results: Time taken for the need of the first rescue analgesic was significantly longer in Group I in comparison to bupivacaine alone with 417.3±276.2 min and 219.6±226.3 min with p=0.001. Total rescue analgesics taken in Group I was significantly lower compared to Group II with 60.73±29.82mg and 73.22±11.55mg respectively with p=0.01. Also, VAS scores were lower in Group I compared to Group II till 2 hours postoperatively with a mean difference of -1.0 and p<0.001.
Conclusion: The present study concludes that administration of combined 16mg dexamethasone and 0.25% bupivacaine intraperitoneally significantly reduces the postoperative need for rescue analgesic and postoperative pain following laparoscopic cholecystectomy in comparison to 0.25% bupivacaine alone.