Comparative evaluation of post-operative analgesic effects of intraperitoneal levobupivacaine plus fentanyl and levobupivacaine plus tramadol in patients undergoing laparoscopic cholecystectomy
Background: Laparoscopic cholecystectomy is commonly performed as a day care procedure for treating symptomatic gallstones. Suitability of patient discharge from the inpatient facility depends upon adequacy of postoperative pain control. Among the various modalities for pain relief, intraperitoneal local anaesthetic has become an important approach. In this study we aimed at comparing the post-operative analgesic effects of intraperitoneal levobupivacaine plus fentanyl and levobupivacaine plus tramadol in patients after laparoscopic cholecystectomy. The objective of this study was to determine which adjuvant drug was superior to the other in terms of prolonging the analgesic effects of levobupivacaine in post-operative period of laparoscopic cholecystectomy.
Methods: A total of 90 patients undergoing laparoscopic cholecystectomy were selected. They were divided into three groups: Group L- received 50 ml of 0.25% levobupivacaine; Group LT- received 0.25% of levobupivacaine and tramadol 2 ml (50 ml total); group LF- received 0.25% levobupivacaine plus fentanyl 2 ml (50 ml total). Postoperative pain was assessed using visual analogue scale.
Results: The combination of levobupivacaine fentanyl and levobupivacaine tramadol was superior to plain levobupivacaine for reducing postoperative pain. No significant difference was found between Group LT and LF with respect to first analgesic and total analgesic requirement. However significant difference was found between LF and L; and between LT and L.
Conclusions: Levobupivacaine should be used along with adjuncts either tramadol or fentanyl.
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