A Prospective Observational Evaluation of Post-Op Pain Management in Elective Laparotomies

Description

Abstract (English)

Abstract
Aim: The aim of the present study was to analyze the post-operative pain management in elective laparotomies
in a tertiary care centre.
Methods: This prospective observational study conducted in the Department of General Surgery, Darbhanga
Medical College and Hospital, Darbhanga, Bihar, India for the period of one year. All patients who underwent
elective laparotomy were provided details about the study and method. Informed written consent was obtained. A
total of 200 patients were included. Detailed history of the patient, condition, surgery performed, analgesics used
were documented. NRS score was calculated.
Results: A total of 200 patients were included among which 40 (40%) were female and 120 (60%) were the male
patients. The patients who underwent elective laparotomies were aged between 20-70 years and 80 (40%) patients
were in the age group of 40-50 years. The 20 different types of surgeries were recorded. The most common surgery
performed in our study was open appendectomy which included 42 (21%) patients followed by open
cholecystectomy (for carcinoma gall bladder and other indications) which included 18 (9%) patients. Most
common was general anaesthesia with transverse plane block which was used in 76 (38%) patients, followed by
general anaesthesia with quadratus lumborum block which was used in 42 (21%) patients. Most common mode
of analgesia used was combined analgesia. Injection tramadol 50 mg in 100 ml normal saline with continuous
epidural bupivacaine followed by injection diclofenac AQ 75 mg in 100 ml N.S with continuous epidural. Severity
of pain gradually reduced from post -operative days 1-3 with the use of various analgesics.
Conclusion: Multimodal analgesia was used in most of the patients for management of post - operative pain
combined analgesia was better mode of pain management method than a single analgesic. Due to different
multimodal analgesics used in different institutions patients experienced different degrees of pain, hence we need
a standard protocol for a best pain management method