Effect of Subdiaphragmatic and Gall Bladder Bed Administration of Bupivacaine on Post Operative Pain and Post Operative Pulmonary Functions in Laparoscopic Cholecystectomy

Pain is an inevitable consequence of any operation and proper attention to the source of pain and its control is needed. The problem of inadequate postoperative pain relief has been recognized for many years and has been the subject of considerable research. In the present research we attempted to study the effect of subdiaphragmatic and Gall Bladder bed administration of bupivacaine on post operative pain and post operative pulmonary Functions in laparoscopic cholecystectomy. MATERIAL AND METHODS: Sixty patients who were admitted and subsequently underwent elective laparoscopic cholecystectomy were included in the present study after taking their informed consent over one year period. Patients were divided into three groups of twenty each. Group I received bupicavaine in both subdiaphragmatic and gallbladder bed region, Group II received bupivacaine in subdiaphragmatic and saline in gallbladder bed region while Group III received normal saline in both region. Postoperative pain scores along with pulmonary functions were assessed and compared with preoperative values. Data was analysed statistically. RESULTS: local instillation of bupivacaine significantly reduced pain scores in the early period after laparoscopic cholecystectomy (p<0.05). The present study also showed more marked fall in pulmonary functions postoperatively as compared to their preoperative values in Group III. CONCLUSION: Subdiapharagmatic and gall bladder bed administration of bupivacaine is an effective, easy and safe method of providing early postoperative analgesia to patients and its administration should be made a routine practice in a standard laparoscopic cholecystectomy.