LAPAROSCOPIC CHOLECYSTECTOMY ; The effect of intraperitoneal instillation of bupivacaine on the mean post - operative pain scores

.. Introduction: Laparoscopic cholecystectomy is the treatment of choice for symptomatic cholelithiasis. Intraperitoneal instillation of bupivacaine is one of the methods used to improve pain relief after laparoscopic cholecystectomy. Objective: To compare the mean pain score after intraperitoneal instillation of bupivacaine with placebo during laparoscopic cholecystectomy. Study Design: Randomized Control trial. Setting: This study was carried out a surgical unit PGMI Lady Reading Hospital and Hayatabad Medical Complex, Peshawar. Duration: The duration of study was 6 months from 15th May to 15th December, 2013. Subjects and Methods: 92 patients in each group were included in study to compare the mean pain score of intraperitoneal instillation of bupivacaine (Group A; study group) with 0.9% normal saline solution (Group B; placebo group) using visual analogue scale after laparoscopic cholecystectomy at 12th hour after surgery. Data was entered in software SPSS version 16.0. T test was used to compare the mean pain scores. Results: The mean age of patients in Group A and B was 41.82 ± 7.34 and 40.95 ± 9.24 respectively (p=0.483). Group A has low mean pain score (3.619 ± 0.676) according to Visual Analogue Scale then Group B (3.837 ± 0.667) with a statistically significant p value (p=0.036). A t test failed to reveal a statistically reliable difference between gender (p=0.513) and age (p=0.767) wise distribution of mean pain between group A and B. Conclusions: Mean pain score of intraperitoneal instillation of bupivacaine is significantly less than 0.9% normal saline solution at 12th hour after laparoscopic cholecystectomy.