The Efficacy of Intraperitoneal Instillation of 0.125% Levobupivacaine versus 0.2% Ropivacaine for Postoperative Analgesia after Laparoscopic Gynecological Surgeries: Comparative Study
- 1. Assistant Professor in Anaesthesiology, Sree Narayana Institute of Medical Sciences, Chalakka, Cochin
- 2. Assistant Professor in Anaesthesiology, Dr. Moopen's Medical College, Meppadi, Wayanad, Kerala
Description
Background and Aim: Most of the gynecological surgeries are now performed under laparoscopy guidance and though minimally invasive majority of patients experience moderate to severe pain in the post operative period. Intraperitoneal instillations of local anaesthetic ropivacaine or levobupivacaine with buprenorphine as adjuvant were compared in this study to find out the efficacy in providing postoperative analgesia. Method: 80 patients belonging to ASA 1 and 2 were divided to two groups of 40 each to receive intraperitoneal instillation of 25 ml of either 0.125% Levobupivacaine (Group B) or 0.2% Ropivacaine (Group R) with 0.3 mg of buprenorphine as adjuvant. Heart rate, blood pressure, respiratory rate, oxygen saturation, numerical rating scale for pain, time to first analgesic request and total analgesic requirement were assessed in the postoperative period. Results: There was no statistically significant difference in mean heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, oxygen saturation, pain scores, time to first analgesic request and total analgesic requirement with all p values more than 0.05. Conclusion: Intraperitoneal instillation of Levobupivacaine and Ropivacaine with buprenorphine as adjuvant is effective and have comparable postoperative analgesia after laparoscopic gynecological surgeries.
Abstract (English)
Background and Aim: Most of the gynecological surgeries are now performed under laparoscopy guidance and though minimally invasive majority of patients experience moderate to severe pain in the post operative period. Intraperitoneal instillations of local anaesthetic ropivacaine or levobupivacaine with buprenorphine as adjuvant were compared in this study to find out the efficacy in providing postoperative analgesia. Method: 80 patients belonging to ASA 1 and 2 were divided to two groups of 40 each to receive intraperitoneal instillation of 25 ml of either 0.125% Levobupivacaine (Group B) or 0.2% Ropivacaine (Group R) with 0.3 mg of buprenorphine as adjuvant. Heart rate, blood pressure, respiratory rate, oxygen saturation, numerical rating scale for pain, time to first analgesic request and total analgesic requirement were assessed in the postoperative period. Results: There was no statistically significant difference in mean heart rate, systolic blood pressure, diastolic blood pressure, respiratory rate, oxygen saturation, pain scores, time to first analgesic request and total analgesic requirement with all p values more than 0.05. Conclusion: Intraperitoneal instillation of Levobupivacaine and Ropivacaine with buprenorphine as adjuvant is effective and have comparable postoperative analgesia after laparoscopic gynecological surgeries.
Files
IJPCR,Vol15,Issue5,Article29.pdf
Files
(370.7 kB)
| Name | Size | Download all |
|---|---|---|
|
md5:78211c395304180cdfe512a13344b5ae
|
370.7 kB | Preview Download |
Additional details
Dates
- Accepted
-
2023-04-30
Software
- Repository URL
- https://impactfactor.org/PDF/IJPCR/15/IJPCR,Vol15,Issue5,Article29.pdf
- Development Status
- Active
References
- 1. Gibbison B, Kinsella SM. Postoperative analgesia for gynecological laparoscopy. Saudi J Anaesth. 2009; 3:70-6. 2. Barkun JS, Sampalls JS, Fried G, Wexler MJ, Meakins JL, Taylor B, et al. Randomised controlled trial of laparoscopic versus mini cholecystectomy. The Lancet. 1992; 340(8828):1116-9. 3. Stiff G, Rhodes M, Kelly A, Telford K, Armstrong CP, Rees BI. Long term pain:less common after laparoscopic than open cholecystectomy. BJS. 1994; 81:1368- 70. 4. Dobbs FF, Kumar V, Alexander JI, Hull MGR. Pain after laparoscopy related to posture and ring versus clip sterilization. BJOG. 1987; 94:262-6. 5. Narchi P, Benhamou D, Fernandez H. Intraperitoneal local anesthetic for shoulder pain after day case laparoscopy. Lancet. 1991; 338:1569–70. 6. Ohmura S, Kawada M, Ohta T. Systemic toxicity and resuscitation in bupivacaine, levobupivacaine, or ropivacaine-infused rats. Anest Analg. 2001; 93:743–8. 7. 7.Goldstein A, Grimault P, Henique A, Keller M, Fortin A, Darai E. Preventing postoperative pain by local anesthetic instillation after laparoscopic gynecologic surgery: A placebocontrolled comparison of Bupivacaine and ropivacaine. Anesthesia & Analgesia. 2000; 91(2):403–7. 8. Kum CK, Wong CW, Goh PM, Ti TK. Comparative study of pain level and analgesic requirement after laparoscopic and open cholecystectomy. Surgical laparoscopy and endoscopy. 1994; 4:139- 41. 9. Tate JJ, Chung SC, Dawson J, Leong HT, Chan A, Lau WY, et al. Conventional versus laparoscopic surgery for acute appendicitis. BJS. 1993; 80:761-4. 10. Suseela I, Anandan K, Aravind A, Kaniyil S. Comparison of ultrasoundguided bilateral subcostal transversus abdominis plane block and port-site infiltration with bupivacaine in laparoscopic cholecystectomy. Indian J Anaesth. 2018 Jul; 62(7):497-501. 11. Rosenblum M, Weller RS, Conard P, Falvey EA, Gross JB. Ibuprofen provides longer lasting analgesia than fentanyl after laparoscopic surgery. Anesth Analg.1991; 73:255-9. 12. Ding Y, White PF. Comparative effects of ketorolac, dezocine, and fentanyl as adjuvants during outpatient anesthesia. Anesth Analg. 1992; 75:566-71. 13. Rivard C, Vogel RI, Teoh D. Effect of Intraperitoneal Bupivacaine on Postoperative Pain in the Gynecologic Oncology Patient. J Minim Invasive Gynecol. 2015;22(7):1260-5. 14. Callesen T, Hjort D, Mogensen T, Schouenborg L, Nielsen D, Reventlid H, et al. Combined field block and i.p. instillation of ropivacaine for pain management after laparoscopic sterilization. Br J Anaesth. 1999; 82:586- 90.