Journal of AdvancedMedical and Dental Sciences Research

Background: Laparoscopic removal is now the procedure of choice when cholecystectomy is indicated. The present study was conducted to compare pre-emptive versus post-surgery IPLA in controlling postoperative pain after elective laparoscopic cholecystectomy in adult patients. Materials & Methods: The present study was conducted on 126 patients with American Society of Anesthesiologists physical status I to III scheduled for laparoscopic cholecystectomy. The primary outcome was the intensity of postoperative pain by visual analogue scale score (VAS) at 30 minute, 1, 2, 4, 6, 24 hours after surgery. The secondary outcomes were analgesic request rate in 24 hours; duration of hospital stay and time to return to normal activity. Results: Group I (Control) patients received 30 ml normal saline at beginning of surgery and at the end of the surgery. Group II patients (preemptive) received 30 ml 0.5% bupivacaine at the beginning of surgery and 30 ml of saline at the end of the surgery and group III patients (post-surgery) received 30 ml of saline at the beginning of surgery and 30 ml of 0.5% bupivacaine at the end of the surgery. VAS after 6 hours in group I was 3.2, in group II was 2.6 and in group III was 2.8. VAS after 24 hours in group I was 4.5, in group II was 3.5 and in group III was 3.9. The difference was significant (P< 0.05). Conclusion: Authors found that Pre-emptive intraperitoneal local anaesthetic instillation resulted in less pain intensity and shoulder pain in patients underwent LC. Key words: Local anaesthetic, Intraperitoneal, laparoscopic cholecystectomy