scholarly journals Intraperitoneal and periportal injection of bupivacaine for pain after laparoscopic cholecystectomy

1970 ◽  
Vol 7 (1) ◽  
pp. 50-53 ◽  
Author(s):  
SK Maharjan ◽  
S Shrestha

Purpose: to study the analgesic efficacy of intraperitoneal and periportal injection of bupivacaine following laparoscopic cholecystectomy. Materials and methods: 40 patients undergoing laparoscopic cholecystectomy were randomized into two groups of 20 each. Group A (study group) received 40 ml of intraperitoneal injection of 0.25% bupivacaine and 20 ml of same concentration in 4 ports, 5 ml each at the end of surgery. Group B (control) received no treatment. Post operative patient monitoring and pain assessment was done by another doctor blinded to the procedure using VAS score at 1,2,3,6,9 and 24 hours after surgery. Pethidine 50 mg intramuscular was given as rescue analgesic when demanded by patient within first 24 hours. Results: when VAS score was analyzed in the two groups, the study group had less scores compared to control group though it was statistically not significant (p > 0.05). The rescue analgesic requirement was significantly less in study group (p < 0.00). Conclusion: Intraperitoneal and periportal injection of bupivacaine is effective in decreasing pain after laparoscopic cholecystectomy. Key words: Laparoscopic surgery, intraperitoneal bupivacaine, analgesia, VAS score     doi: 10.3126/kumj.v7i1.1765       Kathmandu University Medical Journal (2009), Vol. 7, No. 1, Issue 25, 50-53         

Author(s):  
Ritu Masar ◽  
Kishore Kumar Arora

Background: To evaluate the effects of preoperative Gabapentin on postoperative relief of pain in patients scheduled for surgery under general anaesthesia. Post-operative ward and OT Department of Anaesthesia, JAH, GR Medical College, Gwalior, Madhya Pradesh, India.Methods: The sixty patients subjected to ASA grade I and II posted for elective surgeries under general anaesthesia were randomized into 2 groups. One and half hour before surgery, Gabapentin 600 mg and placebo was given blindly to selected patients for the study. The postoperative pain was assessed with visual analogue score. Pain and side effects assessment were performed.Results: Total 60 patients of ASA grade I and II posted for elective surgeries under GA were randomized into 2 groups. One and half hour before surgery, the drug selected for the study was given blindly with a sip of water. The mean (±SD) of VAS score was 5.86±0.34 in Group B and 5.10±0.84 in Group A. VAS score was significantly lower in Group A. With oral Gabapentin time required for rescue analgesia is delayed as compared to control group. The mean (±SD) TRA-1 was 38.40±24.61 in Group B and 44.03±8.94 in Group A.Conclusions: Preoperative oral Gabapentin significantly decreases the severity of pain postoperatively as compared to placebo in patients posted for surgery. Time for analgesic requirement is more with oral Gabapentin. The VAS score was lower in Gabapentin group.


2007 ◽  
Vol 122 (6) ◽  
pp. 603-608 ◽  
Author(s):  
S Elwany ◽  
Y A Nour ◽  
E A Magdy

AbstractIntroduction:Laryngopharyngeal reflux is increasingly being implicated in several otolaryngological disorders.Aims:To study a potential correlation between pre-operative laryngopharyngeal reflux and wound healing and recovery after tonsillectomy, based on subjective and objective findings.Materials and methods:A prospective, blinded study was undertaken, including 60 patients scheduled for tonsillectomy, divided into two equal groups: a study group (group A) with pre-operative laryngopharyngeal reflux documented using ambulatory 24-hour pH monitoring; and a control group (group B) without laryngopharyngeal reflux.Results:Group A had significantly higher pain scores on the seventh and 14th post-operative days (p = 0.022 and p = 0.000, respectively) and took a significantly longer time to return to normal eating (p = 0.013), compared with group B. Group A also showed significantly slower healing on the seventh and 14th post-operative days, as estimated by assessing the grade of post-operative slough formation (p = 0.016 and p = 0.029, respectively). A significant correlation between the number of pharyngeal reflux episodes and the degree of post-operative slough was also found.Conclusions:Laryngopharyngeal reflux can significantly decrease wound healing following tonsillectomy. Therefore, pre-operative recognition and management of this condition is desirable in order to eliminate its negative post-operative effect.


2018 ◽  
Vol 46 (11) ◽  
pp. 4535-4538 ◽  
Author(s):  
Hagay Orbach ◽  
Nimrod Rozen ◽  
Barak Rinat ◽  
Guy Rubin

Objective This study aimed to compare analgesic efficacy and safety of different volumes of lidocaine injected into a fracture hematoma (hematoma block [HB]) for reducing distal radius fractures. Methods Patients were randomly divided into two groups. Group A included patients in whom 10 mL of 2% lidocaine was injected into the fracture site and group B included patients in whom 20 mL of 1% lidocaine was injected. The fracture was manipulated after 15 minutes and the Visual Analogue Scale (VAS) score was recorded during manipulation. Patients were followed up for approximately 1 hour and complications were recorded. Results Twenty patients were enrolled in the study (12 women and eight men), with a mean age of 57 years (range, 32–87 years). Demographic findings were similar between the groups. The mean VAS score of group A was 5.50 ± 3.57 and that in group B was 3.09 ± 2.33, with no significant difference between the groups. Conclusion VAS scores between HB with 20 mL of 1% lidocaine and HB with 10 mL of 2% lidocaine are not significantly different. However, our study suggests that HB with 20 mL of 1% lidocaine has a better analgesic effect than HB with 10 mL of 2% lidocaine.


2016 ◽  
Vol 3 (2) ◽  
pp. 41 ◽  
Author(s):  
Mahesh Sharma ◽  
Kalpana Kharbuja ◽  
Nil Raj Sharma

Introduction: Laparoscopic cholecystectomy has been the gold standard in the treatment of gallstones since last decades. Beside several benefits of laparoscopic cholecystectomy compared with open surgery, postoperative pain is still a frequent melancholy.  Hence, pain management is utmost regarding patients' comfort. The main objective of the study was to compare the effect of intraperitoneal hydrocortisone plus bupivacaine with bupivacaine alone on pain relief following laparoscopic cholecystectomy.   Methods: A randomized study was conducted from December 2015 to August 2015 that included 100 patients aged 20 to 60 years of both genders who were found to have symptomatic gallstones and were scheduled for elective laparoscopic cholecystectomy at Lumbini Medical College. Patients randomly received 100 mg hydrocortisone plus 100 mg bupivacaine in 200 ml normal saline (group A) or 100 mg bupivacaine in 200 ml normal saline (group B) into the peritoneum. Post-operative abdominal and shoulder pain were evaluated using Visual Analog Score (VAS). The patients were also followed up for postoperative analgesic requirements, and recovery variables. Data were collected, tabulated and analyzed statistically using SPSS version 19.   Results: Total number of patients in this study were 100. Age and gender among both groups were comparable. VAS scores for pain was significantly lower for group A as compared to group B at 0, 2, 4, 6, 12, and 24 hours. Time of oral intake in hrs for liquids and solids was statistically significant in Group A compared to Group B. Rescue analgesic requirement was also significantly low in Group A compared to Group B. Hospital stay in both group were comparable.   Conclusion: Combination of hydrocortisone plus bupivacaine can relieve pain after laparoscopic cholecystectomy better compared to bupivacaine alone when administered intraperitoneally.


2021 ◽  
Vol 81 (01) ◽  
pp. 5-12
Author(s):  
Eduardo Reyna-Villasmil ◽  
◽  
Jorly Mejía-Montilla ◽  
Nadia Reyna-Villasmil ◽  
Duly Torres-Cepeda ◽  
...  

Objective: To establish the diagnostic utility of the platelet-lymphocyte ratio in pregnant women with preeclampsia. Methods: A case-control study was carried out at the Hospital Central “Dr. Urquinaona” Maracaibo, Venezuela. A total of 180 pregnant women were selected. Ninety preeclamptic women were included as the study group (group A) and a control group selected for their age and body mass index similar to the study group, which consisted of 90 healthy normotensive pregnant women (group B). The general characteristics, platelet-lymphocyte ratio values and diagnostic efficacy were determined. Results: Group A patients presented lower platelet and lymphocyte values compared to group B patients (p <0.001). However, no statistically significant differences were found in platelet-lymphocyte ratio between group A patients (115.2 ± 32.7) and group B patients (122.3 ± 23.8; p = 0, 0971). A cut-off value of the platelets-lymphocyte ratio of 117 presented a value below the curve of 0.57, the sensitivity of 47.8%, the specificity of 50.0%, the positive predictive value of 48.9%, and the negative predictive value of 52.2%, with a diagnostic accuracy of 48.9%. Conclusion: Platelet-lymphocyte ratio is not a useful tool in the diagnosis of preeclampsia, since patients with the syndrome present similar values to normotensive pregnant women. Keywords: Platelet-lymphocyte ratio, Preeclampsia, Diagnosis, Pregnancy.


2021 ◽  
Vol 9 (4) ◽  
pp. 89
Author(s):  
Jing Luo

<p><span lang="EN-US">Objective: to explore the application value of coagulation function test in the prognosis of patients with cardiovascular and cerebrovascular diseases. Methods: from December 2018 to December 2019, 100 patients with cardiovascular and cerebrovascular diseases were randomly selected as the study group. According to the follow-up results of patients, they were divided into study group A (good prognosis, n = 64) and study group B (disability or death, n = 36) 100 subjects served as the control group. The test results of coagulation function of the two groups were analyzed retrospectively. The test results of the study group before and after treatment were compared with those of the control group, and the test results of the study group A and study group B after treatment were compared. Results: the coagulation function of the study group after treatment was significantly improved compared with that before treatment (P &lt; 0.05), and there was a significant difference between the two groups before treatment (P &lt; 0.05), and there was no difference after treatment (P &gt; 0.05); after treatment, the coagulation function of study group A and study B was significantly different (P &lt; 0.05). Conclusion: coagulation function test has a certain application value for the prognosis of patients with cardiovascular and cerebrovascular diseases, and can be used as an index to judge the patient’s condition and treatment effect, which has good application value in clinical practice.</span></p>


2021 ◽  
Author(s):  
Laijian Sui ◽  
Aihua Jiang ◽  
Pengzhou Gai ◽  
Xiaojun Qi ◽  
Jinwei Wang ◽  
...  

Abstract Background: The present study was designed to investigate the safety and effectiveness of iced normal saline combined with cocktail perfusion during total knee arthroplasty (TKA).Method: Sixty patients undergoing TKA were divided into three groups, then three different intro-operative articular cavity perfusion treatment was given according to the randomized, double-blind and controlled rule. One way ANOVA analysis on visual analogue scale (VAS) score, functional recovery, drainage, and edema of the affected limb were performed to assess the efficiency of the treatment in the following three days after the operation.Results: Postoperative drainage in group A and B reduced significantly (P<0.05). The IHC scores of the surgical limbs were markedly lower comparing with the control group (P<0.05). No differential postoperative edema was observed and the patient acquired better rehabilitation in group A and B than control group. Compared with group A, no differential postoperative drainage and edema was seen in group B (P>0.05). The VAS score of group B was significantly lower than in group A(P<0.05). Postoperative recovery of the surgical limb function in group B was better than in group A (P<0.05), and PGE2 in the postoperative drainage volume of group B was significantly decreased (P<0.05).Conclusions: Intra-operation articular cavity perfusion therapy with iced normal saline combined with cocktail perfusion therapy can greatly reduce the early inflammation, contributing to the better rehabilitation of TKA.


2021 ◽  
Vol 23 (05) ◽  
pp. 421-432
Author(s):  
Dr. Mohammad Kheiri Mahmod ◽  
◽  
Dr. Bashar Naser Hussein ◽  
Dr. Ammar Hamid Hanoosh ◽  
◽  
...  

Background: The physiological consequences of post-operative pain including Stress response to surgery, Respiratory complications, cardiovascular complications, Thromboembolic complications, Gastrointestinal complications, Musculoskeletal complications and Psychological complications, all of which could delay or impair postoperative recovery and increase the economic cost of surgery as a result of the longer period of hospitalization. Inadequate post-operative pain control may also lead to the development of chronic pain after surgery .Aim of This study: is to evaluate the preemptive analgesic effect of intravenous ketamine in laparoscopic cholecystectomy. Patients and Methods: double blinded randomized clinical trial conducted at Al-Yarmouk teaching hospital, over a period of one year from March 2013 to March 2014 on a total of 120 adult patients scheduled for elective laparoscopic cholecystectomy, Patients were divided in to three groups of 40 patients each, the study drug administered intravenously during induction. Groups A and B received ketamine in a dose of 1 and 0.5 mg/kg, respectively, whereas group C received isotonic saline. The degree of pain at rest and deep breathing postoperatively were estimated using VAS, time of first analgesic dose, total opioid consumption, nausea, vomiting and hallucination were recorded for 24 h postoperatively. Results: postoperative pain scores were significantly low in group A when compared with the other groups at most times in the first 24 hours. Highest pain score was in group C at 0 h. Postoperative analgesic consumption was minimum in group A then group B and highest in group C. There was little significant difference in the pain scores between groups B and C. Group A had a significantly higher blood MAP than group B at 0, 0.5 and 1 h. 7.5% incidence of hallucinations were in group A. Conclusion: According to this study we conclude that preemptive ketamine in a dose of 1 mg/kg has a definitive role in reducing postoperative pain and analgesic requirement in patients undergoing laparoscopic cholecystectomy. A low dose of 0.5 mg/kg had little significant in preemptive analgesic effect and in reducing analgesic requirement.


2009 ◽  
Vol 20 (1) ◽  
pp. 24-29 ◽  
Author(s):  
Md Rafiqul Hasan Khan ◽  
Md Zohirul Islam ◽  
Md Sazzad Hossain ◽  
Lutful Aziz ◽  
SN Samad Choudhury

Under treatment of postoperative pain has been the topic of several recent editorials. The prevention, recognition, and management of postoperative pain in adults, as well as in children, have been receiving a great deal of interest. The poor outcome obtained with current regimens is primarily due to the inadequacies of drug administration techniques rather than the qualities of opioids themselves. In this prospective study comparison of preemptive use of diclofenac, ketorolac and tramadol was done for postoperative pain in laparoscopic cholecystectomy. 60 patients were divided into three groups. Group A received injection Diclofenac (3mg/kg) 75mg maximum at a time. Group B received injection Ketorolac (30 mg). And group C patients received injection Tramadol (100 mg). All drugs were given intravenous half an hour before induction. Analgesic efficacy was measured in VAS scale. In addition pulse, systolic blood pressure, diastolic blood pressure, mean blood pressure, total pethidine requirement and time of first pethidine requirement were recorded Patients received an increment of 10-20 mg of pethidine when pain score was 3-4. In this study, total pethidine consumption in group A is 56.5±5.14, in group B is 46.75±4.65 and in group C is 49±5.42. It shows that group B and group C have same analgesic effectiveness and which is better than group A. On the basis of present prospective clinical study postoperative pain can be managed by preemptive use of diclofenac, ketorolac and tramadol. The analgesic efficacy of ketorolac and tramadol is same and better than diclofenac. Key Words: Pre-emptive analgesia, Laparoscopic cholecystectomy. Journal of BSA, Vol. 20, No. 1, January 2007 p.24-29


2019 ◽  
Vol 8 (1) ◽  
pp. 29-33
Author(s):  
Tabish Hussain ◽  
Asifa Anwar Mir ◽  
Jawad Zahir ◽  
Pervaiz Minhas

Background: Postoperative pain creates complications by increasing circulating level of catecholamines and systemic vascular resistance, thus putting the patients on increased risks of having stroke and myocardial infarction. In addition, it increases hospital stay, causing burden over economic as well as healthcare infrastructure. The aim of this study was to determine the frequency of pain in the postoperative period while using Pregabalin as pre-medication among patients undergoing laparoscopic cholecystectomy.Material and Methods: The randomized control trail was conducted at Department of Anesthesiology, Holy Family hospital, Rawalpindi from 1st Sept 2015 to 28th Feb 2016 over a period of 6 months. A total of 200 patients undergoing laparoscopic cholecystectomy were randomly divided in group A and B by consecutive non-probability lottery method. Group A received 100 mg oral Pregabalin 1 hour before surgery and Group B were not given Pregabalin and were taken as controls. Post-operative pain was measured by visual analog scale (VAS) in terms of pain scores at 4 hours postoperatively after the arrival of patient in the post-anesthesia care unit (PACU). SPSS version 17.0 was used to analyze the data.Results: A total of 200 patients were included in the study. There were 100 patients in each group. Based on the visual analog pain scores, 9 patients were pain free in group A compared with none in group B. Similarly, there were 55 patients in group A, who reported a pain score of 1 whereas no patient in group B had a VAS score of 1. There were 29 patients in group A and only 3 patients in group B with VAS score of 2 (90.6% vs. 9.4%). For VAS score of 3, there were 6 patients in group A and 34 patients from group B (15% vs. 85%). For a VAS score of 4, there were 1 patient in group A and 61 patients in group B (1.6% vs. 98.4%). Two patients in group B experienced a VAS score of 5. All this data was significant with chi square p value of 0.0001.Conclusion: Oral Pregabalin administered prior to laparoscopic cholecystectomy was effective in reducing postoperative pain in the patients. Further studies are needed for post-operative evaluation of side effects, different dosing schedules at different time intervals for both rest and dynamic pain.


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