Zastosowanie dootrzewnowej iniekcji bupiwakainy do leczenia bólu po laparoskopowej cholecystektomii

Abstract

Introduction. Lately, intraperitoneal injection of local analgesics has been practised as an element of postoperative multimodal anaesthesia in some minimally invasive gynaecologic surgical interventions. Aim. To analyse efficacy of intraperitoneal bupivacaine injection for pain relief after laparoscopic cholecystectomy. Material and methods. Randomized double-blind clinical examination included 28 patients, aged between 32 and 60 (16 women and 12 men) who had undergone laparoscopic cholecystectomy. Patients were randomly divided into 2 groups, depending on whether bupivacaine had been applied for 24 hours in complex early postoperative anaesthesia (0.125% solution intraperitoneally, in a dose of 0.6 ml/kg (0.7 mg/kg of bupivacaine substance), every 6 hours). Patients’ condition was assessed on a visual analogue scale (VAS) 1, 4, 8, 12, and 24 hours after surgery. In addition, average number of fentanyl (mcg/kg) that had been used for a single pain relief was established. Results. Intraperitoneal bupivacaine injection after laparoscopic cholecystectomy had marked analgesic effect which revealed itself in reliable 1.47-1.77 times decrease in pain index on the VAS, and 1.55 times decrease in the analgesic dose of fentanyl. Conclusions. It seems to be appropriate to use intraperitoneal bupivacaine injection as a part of comprehensive multimodal anaesthesia in early postoperative period after laparoscopic cholecystectomy.