scholarly journals COMPARATIVE STUDY OF POST OPERATIVE PAIN RELIEF IN LAPAROSCOPIC CHOLECYSTECTOMY WITH PORT SITE AND INTRAPERITONEAL INSTILLATION OF 0.5% BUPIVACAINE WITH ADRENALINE AND PLACEBO

2021 ◽  
pp. 24-25
Author(s):  
Vivek Agrawal ◽  
Parikshit Bishnoi ◽  
Anand Nagar ◽  
Shireesh Gupta ◽  
Anshul Mathur ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Comparative Study ◽  
Local Anaesthetic ◽  
Anaesthetic Agent ◽  
Port Site ◽  
Local Infiltration ◽  
Early Return ◽  
Post Operative Pain ◽  
Intraperitoneal Instillation ◽  
Improve Cost

Introduction : Postoperative pain is variable in intensity,character,duration and is the main factor delaying discharge of patients undergoing day-care procedures including laparoscopy and hence adding to hospital cost and stay. Optimal management has a potential for shortening of hospital stay and for speeding up of recovery.AIM :Comparing the effect of port site and intraperitoneal instillation of 0.5% bupivacaine with adrenaline versus saline for post-operative analgesia in laparoscopic cholecystectomy. To assess the need of rescue analgesics in post- operative period in both groups.Material & Method :A comparative study to be performed on 50 cases receive 40 mls of 0.5% bupivacaine as intraperitoneal infiltration and local infiltration of 20 mls of 0.5% bupivacaine in the port sites (5 ml infiltration in each port) versus 50 cases receive 40 ml of normal saline intraperitoneally Discussion :Reduction in post-operative pain with better cosmesis and early return to work have been the goals to improve cost effectiveness and patient satisfaction. Conclusion : We conclude that instillation of local anaesthetic drug intraperitonialy & Port site local anaesthetic agent injection has added benefits in post operative pain

Assessment of Effect of Port Site and Intraperitoneal Instillation of Bupivacaine in Reduction of Post-Operative Pain After Laparoscopic Cholecystectomy

2020 ◽  
Author(s):  
Nippun Roy
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Pain Assessment ◽  
Pain Control ◽  
Port Site ◽  
Controlled Study ◽  
Control Group ◽  
Local Infiltration ◽  
Pain Scores ◽  
Post Operative Pain ◽  
Intraperitoneal Instillation

Aim: Effective postoperative pain control is an essential component for care of surgical patients. Inadequate pain control may result in increased morbidity or mortality. Analgesic effects of periportal infiltration of local anesthetics, infiltration of periportal parietal peritoneum, intraperitoneal spraying at subdiaphragmatic space and subhepatic space covering the area of hepatoduodenal ligament have been reported. The present controlled study aimed at assessing the effect of port site injection and intraperitoneal instillation of bupivacaine in reduction of post-operative pain after laparoscopic cholecystectomy. Methods: The present study was conducted among a group of 180 patients diagnosed to have symptomatic cholelithiasis and who underwent elective laparoscopic cholecystectomy under general anesthesia. In group 1, pre-incisional local infiltration of 20ml 0.5% bupivacaine at the port sites; and in group 2, local infiltration of 20ml 0.5% bupivacaine at the port sites with intraperitonial installation. In group 3, no local infiltration was done and treated as control group. Pain assessment is based on a Universal Pain Assessment Tool. Analysis of our study was performed one-way ANOVA & Post HOC test (Scheffe's HSD) & Chi square tests as and when indicated. Results: Mean pain scores at 30 minutes were significantly lower in groups 1 & 2 compared to control group; but however, the values were not significantly different when compared to each other. Similarly, the mean pain scores at 4th, 8th, 16th and 24th hours for the preincisional and preclosure groups, didn't signify any inter-group advantage. Therefore, bupivacaine provides a substantial reduction of pain intensity up to 24 hours postoperatively; and was found to be statistically significant. However, timing of anesthesia was found to be statistically insignificant in terms of preclosure vs pre incisional of the port sites. Conclusion: Instillation of bupivacaine at the port sites in laparoscopic cholecystectomy irrespective of the timing of instillation is an effective method of achieving pain control in the post-operative period as long as 24 hours after surgery. There was no statistically significant reduction of post-operative pain between the pre-incisional and pre-closure groups.

scholarly journals EPIGASTRIC VS. UMBILICAL PORT FOR RETRIEVAL IN LAPAROSCOPIC CHOLECYSTECTOMY : WHICH IS BETTER

2020 ◽  
pp. 1-2
Author(s):  
Zayd Ashok ◽  
Priyanka pant
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Gall Bladder ◽  
Standard Treatment ◽  
Single Incision ◽  
Technical Difficulty ◽  
Port Site ◽  
Post Operative Pain ◽  
Port Site Hernia ◽  
Day By Day ◽  
Site Pain

Background and aim - Cholilithiasis is most common cause for cholecystectomy. These days laparoscopic cholecystectomy is the standard treatment for cholilithiasis. Extraction of gall bladder is an important cause for post operative pain after cholecystectomy. Laparoscopic cholecystectomy is still evolving, the number of ports are being reduced day by day. From standard four port to single incision and using natural orifices (NOTES). This study was done to determine whether the patients undergoing gall bladder retrieval via umbilical port was associated with more complications than epigastric port in a standard four port laparoscopic cholecystectomy. Method - 400 patients were selected for the study and were randomly allocated into 2 groups. Postoperatively, port-site pain score assessed at 2, 6, 12, and 24 hours by visual analog scale (VAS) score both for the epigastric and umbilical ports in all the patients and other variables are assesed accordingly and the collected data were analyzed by using SPSS version 22. Result - The postoperative pain and spillage was more in retrieval via epigastric port with only mild technical difficulty and relatively higher incidence of port site hernia from the retrieval port in retrieval via umbilical port.

scholarly journals A comparative study of postoperative port-site pain after gallbladder retrieval from umbilical versus epigastric ports in laparoscopic cholecystectomy

2019 ◽  
Vol 8 (5) ◽  
pp. 1617 ◽  
Author(s):  
Ranendra Hajong ◽  
MalayaRanjan Dhal ◽  
Tanie Natung ◽  
Donkupar Khongwar ◽  
ArupBaruah Jyoti ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Comparative Study ◽  
Port Site ◽  
Site Pain

scholarly journals Port Site Infiltration and Intraperitoneal Instillation of Bupivacaine for Post Operative Analgesia in Laparoscopic Cholecystectomy

2020 ◽  
Vol 14 (2) ◽  
pp. 58-61 ◽  
Author(s):  
Lipika Sanjowal ◽  
Swapan Kumar Biswas
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Study Groups ◽  
Treatment Method ◽  
Port Site ◽  
Control Group ◽  
Vas Score ◽  
Intraperitoneal Instillation ◽  
Elective Laparoscopic Cholecystectomy ◽  
Experimental Group

Laparoscopic cholecystectomy has become the gold standard treatment method for symptomatic gallstone diseases. However pain is the only complaint that delays the discharge. This study aimed to evaluate the efficacy of bupivacaine infiltration into port site and instillation into peritoneal cavity to reduce pain following laparoscopic cholecystectomy. One hundred patients underwent elective laparoscopic cholecystectomy enrolled in this study. Patients were divided into experimental group (Group A) and control group (Group B) of 50 patients each. Following removal of gallbladder, patients of experimental group received 20 ml of 0.5% bupivacaine in gallbladder bed and 20 ml of 0.5% bupivacaine was infiltrated into 4 port sites. Control group received no treatment. The evaluation of postoperative pain was done at 4, 8, 12 and 24 hours postoperatively by using Visual Analogue Scale and the dose of NSAID was also recorded. Mean VAS score at 4, 8 and 12 hours postoperatively in experimental group was less than that of the control group (p<0.05). VAS score at 24 hours postoperatively did not differ between two study groups (p>0.05). The mean total NSAID doses used during first 24 hours postoperatively was less in the experimental group than control group (p<0.05). The localization of pain during first 24 hours postoperatively was 62% incisional, 29% intra abdominal and shoulder tip pain 9%. Port site infiltration and intraperitoneal instillation of bupivacaine following laparoscopic cholecystectomy reduce pain following laparoscopic cholecystectomy and this simple, inexpensive and effective method should be practiced to minimize early postoperative pain for all elective laparoscopic cholecystectomy. Faridpur Med. Coll. J. Jul 2019;14(2): 58-61

scholarly journals Complications of Laproscopic Cholecystectomy in Patients of Acute Cholecystitis

2021 ◽  
Vol 15 (8) ◽  
pp. 2477-2479
Author(s):  
Haseena Rehman ◽  
Gul Lalley ◽  
Gul Sharif ◽  
Asim Shafi ◽  
Asif Mehmood ◽  
...  
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Wound Infection ◽  
Acute Cholecystitis ◽  
Port Site ◽  
Treatment Procedure ◽  
Post Operative Pain ◽  
Port Site Hernia ◽  
Complications Of Laparoscopic Cholecystectomy ◽  
Bladder Diseases ◽  
History Of

Objective: To determine the complications of laparoscopic cholecystectomy in patients of acute cholecystitis. Study Design: Prospective study. Place & Duration: Department of Surgery, Lady Reading Hospital, Peshawar for duration of six months from January 2020 to June 2020. Methods: Total 120 patients of both genders with ages 20 to 60 years were included in this study. Patients’ detailed demographics were recorded after taking written consent. Patients with history of abdominal surgery were excluded. All the patients underwent laparoscopic cholecystectomy for gall bladder diseases. Post-operative pain was analyzed by VAS. Complications were recorded at 5th postoperative day. Data was analyzed by SPSS 24.0. Results: Out of 120 patients 30 (25%) patients were males and 75% patients were females. Most of the patients 50 (41.67%) were in the age group 31 to 40 years followed by 37 (30.83%) patients were ages between 41 to 50 years. 70 (58.33%) patients had surgical size port incision was 5mm and 50 (41.67%) patients had 10mm. Mean pain score was 2.24+1.1 at 5th postoperative day. Wound infection was found in 10 (8.33%). Port site hernia was found in 12 (10%). Conclusion: Laparoscopic cholecystectomy is safe and effective treatment procedure with no major complications. Keywords: Laparoscopic Cholecystectomy, Acute Cholecystitis, Wound Infection, Port Site Hernia, Pain

COMPARING THE POST-OPERATIVE ANALGESIA USING ROPIVACAINE IN LAPAROSCOPIC CHOLECYSTECTOMY BY THREE DIFFERENT METHODS-A COMPARATIVE STUDY

2021 ◽  
pp. 16-19
Author(s):  
Nimta Kishore ◽  
Trilok Chand ◽  
Narendra Singh Poniya ◽  
Arpita Saxena
Keyword(s):  
Laparoscopic Cholecystectomy ◽  
Postoperative Pain ◽  
Pain Relief ◽  
Transversus Abdominis Plane Block ◽  
Port Site ◽  
Transversus Abdominis ◽  
Postoperative Pain Relief ◽  
Tap Block ◽  
Transversus Abdominis Plane ◽  
Intraperitoneal Instillation

Introduction: Laparoscopic cholecystectomy is a minimally invasive surgical procedure for cholecystectomy. In present time local anesthesia is widely used as analgesic by various routes including port site intraincisional inlteration, transverse abdominis plane (TAP) block and intraperitoneal instillation. Aim: Comparing The Post-Operative Analgesia Using Ropivacaine in Laparoscopic Cholecystectomy by three Different Methods ; Intraperitoneal instillation, USG-guided subcostal transversus abdominis plane block and Incisional inltration at port site. Materials and methods: This study was conducted among elective general surgical patient undergoing laparoscopic cholecystectomy in S.N. Medical College, Agra and completed in the study period of 18 months. Study population was elective surgical patients posted for elective laparoscopic cholecystectomy. Patients were divided in to 3 groups: Group A- Intraperitoneal instillation, Groups B- ultrasound guided subcostal transversus abdominis plane block and Groups C- intraincisional inlteration at port site. Results: Intraincisional inltration of ropivacaine provide signicant Postoperative pain relief in comparative to USG -guided subcostal TAP block and intraperitoneal instillation with ropivacaine. Conclusion: Intraincisional inltration of ropivacaine provide signicant Postoperative pain relief and decrease post operative analgesia requirement in comparative to USG -guided subcostal TAP block and intraperitoneal instillation with ropivacaine. Shoulder tip pain incidence, postoperative nausea and vomiting incidence lower in intraincisional inltration of ropivacaine.

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