Decreasing the postoperative pain and shoulder pain following LC: Any good alternative?

MD, Bak�?±rkoy Dr.Sadi Konuk Traning and Research Hospital, Deparatment of Surgery, Istanbul, Turkey MD, Lutfiye Nuri Burat State Hospital, Department of General suregery, Istanbul, Turkey MD, Lutfiye Nuri Burat State Hospital, Department of Anesthesiology, Istanbul, Turkey MD, Haydarpasa Numune Traning and Research Hospital, Istanbul, Turkey

Scientific Tracks Abstracts: J Univer Surg

Abstract:

Background: Postoperative pain and shoulder pain are the major complaints following laparoscopic cholecystectomy (LC). The aim of this study was to compare the impact of intraperitoneal bupivacaine versus spinal epidural anesthesia on pain relief after LC. Patients & Methods: In a retrospective clinical study, there were three groups: group 1 (n: 49) LC under general anesthesia with intraperitoneal instillation with bupivacaine; group 2 (n: 51) LC under spinal epidural anesthesia and group 3 (n: 50) LC under general anesthesia. Patients were investigated regarding abdominal and shoulder pain (SP) using visual analog scale (VAS) in recovery room and at 6th, 12th and 24th hours postoperatively. Patients were also followed regarding postoperative analgesic requirements, nausea and vomiting, hypotension and patient satisfaction. Results: There was no statistically significant difference in terms of gender, age, ASA, BMI mean among the groups. Patient satisfaction was higher in group 1 than group 2 and group 3 and statistically significant (4.89±0.30, 4.01±0.73, 3.28±0.49 respectively, p<0.001). SP just at the end of operation and 6th hours averages were statistically higher in group 3 compared to group 1 and group 2. On follow-up, the mean of SP 12th hour and 24 hours were found to be statistically significantly higher in group 2 than in group 1 (p<0.001). VAS just at the end of operation and 12th hour were statistically significantly higher in general group 3 than in group 1 and group 2, and in group 1 according to group 2. 6 hours and 24 hours VAS of group 3 was significantly higher than group1 and group2 (p<0.001). Conclusions: Intraperitoneal bupivacaine washing in LC cases performed under general anesthesia or performing LC under spinal epidural anesthesia may be good options to reduce post operative pain/ shoulder pain and analgesic needs.

Biography :

Turgut Donmez has completed his PhD from Istanbul University and Postdoctoral studies from Istanbul University Cerrahpasa School of Medicine. He is the Director of Premier General Surgery service organization. More than 40 articles and reports have been published in well-known magazines. He serves as a Member of arbitration in international scientific journals.

E-mail: surgeont73@hotmail.com

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