Postoperative Pain Clinical Trial
Official title:
Post-operative Pain Relief in Laparoscopic Cholecystectomy Using a Combination of Intraperitoneal Bupivacaine Morphine, Bupivacaine Fentanyl and Bupivacaine Ketamine: A Comparative Study
compare the analgesic efficacy of the combination of bupivacaine and morphine, bupivacaine and fentanyl and bupivacaine and ketamine in alleviating post operative pain following laparoscopic cholecystectomy.
Laparoscopic cholecystectomy is comparatively advantageous over open cholecystectomy in pain
management with shorter duration of hospital stays. Pain management is medically pertinent
for optimal care in surgical patients. Although development and advancement in understanding
of the patho-physiology of pain, analgesics, pharmacology and the development of better
effective techniques for post-operative pain control, patients still continue to experience
considerable discomfort.
Laparotomy results in parietal pain, whereas laparoscopy has a visceral component, a somatic
component and shoulder pain secondary to diaphragmatic irritation because of CO2
pneumo-peritoneum. Postoperative pain associated with laparoscopic cholecystectomy, although
less severe and of shorter duration than that after open cholecystectomy, is still a source
of marked discomfort and surgical stress. The degree of the pain after laparoscopic
procedures has multifactorial influence including the volume of residual gas, type of gas
used for pneumo-peritoneum, pressure created by the pneumo-peritoneum and insufflated gas
temperature.
Local anesthetic infiltration of the incision sites decreases postoperative opiate
requirement and improves subjective pain scores but does eliminate the pain.
Earlier scientists have also reported several beneficial effects of the intra-peritoneal
application of bupivacaine with morphine on postoperative pain management after laparoscopic
cholecystectomy.
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