15428
document
Intraperitoneal application of bupivacaine plus morphine for pain relief after laparoscopic cholecystectomy . BACKGROUND AND OBJECTIVE Intraperitoneal administration of a local anaesthetic in combination with an opioid , for the relief of postoperative pain , has already been reported except after laparoscopic cholecystectomy . This study was aimed at assessing the analgesic effect of the intraperitoneal administration of bupivacaine and morphine in patients undergoing laparoscopic cholecystectomy . METHODS At the end of laparoscopic cholecystectomy , in a double-blind , randomized manner , one of the following injections was given intraperitoneally . There were 30 patients in each group : Group 1 , physiological saline 30 mL ; Group 2 , bupivacaine 0.25 % 30 mL ; Group 3 , bupivacaine 0.25 % 30 mL plus morphine 2 mg . In addition , Group 2 received 2 mg intravenous ( i.v . ) morphine in 2 mL saline , and Groups 1 and 3 , 2 mL saline intravenously . Patients ' postoperative pain was evaluated using a visual analogue scale and a verbal rating score . The postoperative analgesic requirement was assessed by the total dose of metamizol administered by an i.v . patient-controlled analgesia ( PCA ) device . Pain , vital signs , supplemental analgesic consumption and side-effects were recorded for all patients for 24 h. RESULTS There were no differences between the three groups regarding pain scores ( at rest and coughing ) during the study except in the first 2 h , when scores were lower for patients receiving intraperitoneal bupivacaine plus i.v . morphine ( P < 0.05 ) . Supplemental consumption of metamizol was significantly lower ( P < 0.05 ) in Group 3 than in Group 1 during the first 6 h after surgery . However , the cumulative doses of metamizol were also lower in Group 2 than in Groups 1 and 3 over the entire study ( 2025 +/- 1044 mg vs. 4925 +/- 1238 and 4125 +/- 1276mg ; P < 0.05 ) . CONCLUSIONS In patients undergoing laparoscopic cholecystectomy , the intraperitoneal administration of morphine plus bupivacaine 0.25 % reduced the analgesic requirements during the first 6 postoperative hours compared with the control group . However , the combination of intraperitoneal bupivacaine 0.25 % and i.v . morphine was more effective for treatment of pain after laparoscopic cholecystectomy .
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Intervention_Pharmacological
bupivacaine
15430
Intervention_Pharmacological
morphine
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Intervention_Pharmacological
bupivacaine
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Intervention_Pharmacological
morphine
15433
Intervention_Pharmacological
physiological saline
15434
Intervention_Pharmacological
bupivacaine
15435
Intervention_Pharmacological
bupivacaine
15436
Intervention_Pharmacological
plus morphine
15437
Intervention_Pharmacological
morphine
15438
Intervention_Pharmacological
saline
15439
Intervention_Pharmacological
bupivacaine
15440
Intervention_Pharmacological
morphine
15441
Intervention_Pharmacological
morphine
15442
Intervention_Pharmacological
bupivacaine
15443
Intervention_Pharmacological
bupivacaine
15444
Intervention_Pharmacological
morphine
15445
Outcome_Pain
pain relief
15446
Outcome_Pain
postoperative pain
15447
Outcome_Pain
postoperative pain
15448
Outcome_Other
visual analogue scale
15449
Outcome_Mental
verbal rating score
15450
Outcome_Other
patient-controlled analgesia ( PCA )
15451
Outcome_Pain
Pain
15452
Outcome_Physical
vital signs
15453
Outcome_Physical
supplemental analgesic consumption
15454
Outcome_Adverse-effects
side-effects
15455
Outcome_Pain
pain scores
15456
Outcome_Physical
Supplemental consumption of metamizol
15457
Outcome_Other
cumulative doses
15458
Outcome_Physical
analgesic requirements
15459
Outcome_Pain
pain
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Participant_Condition
laparoscopic cholecystectomy .
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Participant_Condition
patients undergoing laparoscopic cholecystectomy .