Comparative Analysis of Post-Operative Analgesia Duration in Laparoscopic Cholecystectomy: Intraperitoneal Bupivacaine Versus Bupivacaine/Buprenorphine Combination
Bupivacaine Versus Buprenorphine in Laparoscopic Cholecystectomy
DOI:
https://doi.org/10.54393/pjhs.v5i06.1677Keywords:
Bupivacaine, Buprenorphine, Laparoscopic Cholecystectomy, Post-Operative AnalgesiaAbstract
Successful pain management following Laparoscopic Cholecystectomy (LC) is essential for a speedy recovery for patients. Intraperitoneal (IP) administration of analgesics, particularly bupivacaine and buprenorphine, offer promising approach to alleviate post-operative pain with minimized systemic side effects. Objective: To compare the duration of post-operative analgesia in patients undergoing laparoscopic cholecystectomy who receive either intraperitoneal bupivacaine alone or a combination of bupivacaine and buprenorphine. Methods: The quasi experimental study was conducted at Department of Anesthesiology, Farooq Hospital, Islamabad from April 2023 to September 2023. Patients scheduled for elective laparoscopic cholecystectomy for symptomatic cholelithiasis or other gallbladder diseases were included. The sampling methodology used was convenience sampling, with patients divided into two groups through the lottery method. Patients were assigned into two groups (55 patients in each group). Group A intraperitoneally received 25 ml dilution of bupivacaine (0.25%) in normal saline. Bupivacaine (0.25%) and buprenorphine (0.3mg) dissolved in normal ub6p B compared to Group A (9.26 ± 1.28 vs. 3.08 ± 1.04 hours, p < 0.001). Results: The mean BMI of participants was 29.79 ± 3.44 kg/m² Group A had 36 (65.5%) women and group B 41 (74.5%). The mean duration of post-operative analgesia was much greater in Group B (9.26 ± 1.28 hours vs. 3.08 ± 1.04 hours, p < 0.001). Conclusions: The combination of bupivacaine and buprenorphine offer post-operative analgesia in laparoscopic cholecystectomy with longer duration as compared to bupivacaine alone which is also statistically significant (p < 0.001).
References
Sousa JH, Tustumi F, Steinman M, Santos OF. Laparoscopic cholecystectomy performed by general surgery residents. Is it safe? How much does it cost?. Revista do Colégio Brasileiro de Cirurgiões. 2021 May; 48: e20202907. doi: 10.1590/0100-6991e-20202907. DOI: https://doi.org/10.1590/0100-6991e-20202907
Di Martino M, Mora-Guzmán I, Jodra VV, Dehesa AS, García DM, Ruiz RC et al. How to predict postoperative complications after early laparoscopic cholecystectomy for acute cholecystitis: the chole-risk score. Journal of Gastrointestinal Surgery. 2021 Nov; 25(11): 2814-22. doi: 10.1007/s11605-021-04956-9. DOI: https://doi.org/10.1007/s11605-021-04956-9
Kurtulus I, Culcu OD, Degerli MS. Which is more effective: laparoscopic or open partial cholecystectomy?. Journal of Laparoendoscopic & Advanced Surgical Techniques. 2022 May; 32(5): 476-84. doi: 10.1089/lap.2021.0300. DOI: https://doi.org/10.1089/lap.2021.0300
Sarkar S, Bose B, Pal B. 10-mm versus 5-mm umbilical port in laparoscopic cholecystectomy: A comparative study in a medical college in Eastern India. Asian Journal of Medical Sciences. 2022 Aug; 13(8): 220-5. doi: 10.3126/ajms.v13i8.44264. DOI: https://doi.org/10.3126/ajms.v13i8.44264
Arif SH. Mini-Laparoscopic Cholecystectomy Versus Standard Laparoscopic Cholecystectomy: A Comparative study. Diyala Journal of Medicine. 2018 Dec; 15(2): 32-43. doi: 10.26505/DJM.15024100521. DOI: https://doi.org/10.26505/DJM.15024100521
Paladini G, Di Carlo S, Musella G, Petrucci E, Scimia P, Ambrosoli A, Cofini V, Fusco P. Continuous wound infiltration of local anesthetics in postoperative pain management: safety, efficacy and current perspectives. Journal of pain research. 2020 Jan 31: 285-94. doi: 10.2147/JPR.S211234 DOI: https://doi.org/10.2147/JPR.S211234
Bobik P, Kosel J, Świrydo P, Tałałaj M, Czaban I, Radziwon W. Comparison of the pharmacological properties of 0.375% bupivacaine with epinephrine, 0.5% ropivacaine and a mixture of bupivacaine with epinephrine and lignocaine-a randomized prospective study. Journal of Plastic Surgery and Hand Surgery. 2020 Jun; 54(3): 156-60. doi: 10.1080/2000656X.2020.1720999. DOI: https://doi.org/10.1080/2000656X.2020.1720999
Jin Z, Ding O, Islam A, Li R, Lin J. Comparison of liposomal bupivacaine and conventional local anesthetic agents in regional anesthesia: a systematic review. Anesthesia & Analgesia. 2021 Jun; 132(6): 1626-34. doi: 10.1213/ANE.0000000000005406. DOI: https://doi.org/10.1213/ANE.0000000000005406
Reddy JS. A study on compare the efficacy of epidural, bupivacaine with buprenorphine and bupivacaine with fentanyl in lower limb surgeries. International Journal of Academic Medicine. 2020; 3(1): 329-35. doi: 10.33545/26643766.2020.v3.i1e.111. DOI: https://doi.org/10.33545/26643766.2020.v3.i1e.111
Prasad D, Ali I, Chaudhary P. A Comparative Study on Effect of Intravenous MGSO4 on Spinal Anaesthesia with Bupivacaine and Buprenorphine. European Journal of Molecular and Clinical Medicine. 2022 Jan; 9(1): 1366-75. doi: 10.4103/aer.aer_39_22. DOI: https://doi.org/10.4103/aer.aer_39_22
Khurana S, Garg K, Grewal A, Kaul TK, Bose A. A comparative study on postoperative pain relief in laparoscopic cholecystectomy: Intraperitoneal bupivacaine versus combination of bupivacaine and buprenorphine. Anesthesia Essays and Researches. 2016 Jan; 10(1): 23-8. doi: 10.4103/0259-1162.164731. DOI: https://doi.org/10.4103/0259-1162.164731
Akbar I, Bukhari S, Shoaib M. Effectiveness of Local Anaesthetic in Reducing Postoperative Pain at Port Site after Laparoscopic Cholecystectomy. Journal of Ayub Medical College Abbottabad-Pakistan. 2022 Oct; 1(3): S695-S698. doi: 10.55519/JAMC-03-S1-10213. DOI: https://doi.org/10.55519/JAMC-03-S1-10213
Haque MI, Bashir HA, Hassan G, Ahmed G. Efficacy of local anesthetic in post-operative laparoscopic cholecystectomy. Scholars Academic and Scientific Journal of Surgery. 2023 Jul; 7: 629-32. doi: 10.36347/sasjs.2023.v09i07.005. doi: 10.36347/sasjs.2023.v09i07.005. DOI: https://doi.org/10.36347/sasjs.2023.v09i07.005
Chaudhary SM, Chohan S, Chaudhary WM. Comparison of Mean Duration of Post-Operative Analgesia in Laparoscopic Cholecystectomy Patients receiving Intra-Peritoneal Bupivacaine versus Bupivacaine plus Buprenorphine. Age (years). 2017 Jan; 47: 9-24.
Sharma CS, Singh M, Rautela RS, Kochhar A, Adlakha N. Comparison of intraperitoneal and periportal bupivacaine and ropivacaine for postoperative pain relief in laparoscopic cholecystectomy: a randomized prospective study. Anaesthesia, Pain & Intensive Care. 2019 Jan: 350-4.
Williams BA, Ibinson JW, Mikolic JM, Boudreaux-Kelly MY, Paiste HJ, Gilbert KL, Bonant SA, Ritter ME, Ezaru CS, Muluk VS, Piva SR. Day-one pain reductions after hip and knee replacement when buprenorphine-clonidine-dexamethasone is added to bupivacaine nerve/plexus blocks: A randomized clinical trial. Pain Medicine. 2022 Jan 1; 23(1): 57-66. doi: 10.1093/pm/pnab325. DOI: https://doi.org/10.1093/pm/pnab325
Manan A, Khan AA, Ahmad I, Usman M, Jamil T, Sajid MA. Intraperitoneal bupivacaine as post-laparoscopic cholecystectomy analgesia. Journal of College of Physicians and Surgeons Pakistan. 2020 Jan; 30(1): 9-12. doi: 10.29271/jcpsp.2020.01.09. DOI: https://doi.org/10.29271/jcpsp.2020.01.09
Mahajan L, Singh AP, Kaur SS, Kumari A. Comparison of the Efficacy of Intraperitoneal Instillation of Butorphanol Versus Nalbuphine as Adjuvants to Ropivacaine for Postoperative Pain Relief in Patients Undergoing Laparoscopic Cholecystectomy Under General Anesthesia: A Randomized, Double-Blind Placebo-Controlled Study. Anesthesia Essays and Researches. 2022 Apr; 16(2): 191-6. doi: 10.4103/aer.aer_74_22. DOI: https://doi.org/10.4103/aer.aer_74_22
Arabzadeh A, Seyedsadeghi M, Sadeghi N, Nejati K, Erdi AM. Comparison of intraperitoneal bupivacaine and intravenous ketorolac for postoperative pain management following Laparoscopic Cholecystectomy. Anesthesiology and Pain Medicine. 2021 Dec; 11(6). doi: 10.5812/aapm.114623. DOI: https://doi.org/10.5812/aapm.114623
Deshmukh P, Parate S, Deshmukh P, Takalkar S. Intrathecal Buprenorphine for Extended Postoperative Analgesia in Patients Undergoing Cesarean Section. Journal of Coastal Life Medicine. 2023 Jan; 11: 2602-7
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2024 Pakistan Journal of Health Sciences
This work is licensed under a Creative Commons Attribution 4.0 International License.
This is an open-access journal and all the published articles / items are distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. For comments