Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial

Abstract Background: The use of intraperitoneally administered local anesthetics as a sole agent or in combination with various types of analgesics has been used increasingly recently. The goal of this study was to compare the effects of intraperitoneal bupivacaine, bupivacaine with magnesium sulfat...

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Main Authors: Santosh Kumar Sahu, Prerna Biswal, Madhusmita Patro, Sushree Das
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2024-04-01
Series:Bali Journal of Anesthesiology
Subjects:
Online Access:https://doi.org/10.4103/bjoa.bjoa_34_24
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author Santosh Kumar Sahu
Prerna Biswal
Madhusmita Patro
Sushree Das
author_facet Santosh Kumar Sahu
Prerna Biswal
Madhusmita Patro
Sushree Das
author_sort Santosh Kumar Sahu
collection DOAJ
description Abstract Background: The use of intraperitoneally administered local anesthetics as a sole agent or in combination with various types of analgesics has been used increasingly recently. The goal of this study was to compare the effects of intraperitoneal bupivacaine, bupivacaine with magnesium sulfate, and bupivacaine with tramadol for postoperative analgesia in laparoscopic cholecystectomy. Materials and Methods: We carried out this prospective, double-blind, randomized trial in 90 patients aged between 20 and 60 years who were randomly divided into three groups. Group B received 25 mL (0.25%) bupivacaine, group T received 25 mL (0.25%) bupivacaine and 100 mg tramadol, and group M received 25 mL of 0.25% bupivacaine and 50 mg/kg of MgSO4. All drugs were administered by intraperitoneal instillation. The Visual Analog Scale (VAS), time of first rescue analgesia, and total dose of rescue analgesia were compared. Results: VAS was significantly higher in group B than in group M at all observed times. The significance also showed when comparing VAS between groups M and T at 4 h (P < 0.001), 6 h (P < 0.001), 12 h (P = 0.001), and 24 h (P < 0.001) postoperatively. Group M showed the longest time to rescue analgesia (22.57 ± 0.97 h, P < 0.001) and the lowest dose requirement of rescue analgesia (P < 0.001). Furthermore, the incidence of postoperative nausea and vomiting was comparable (5 vs. 1 vs. 5, respectively, P = 0.191). Conclusion: Intraperitoneal instillation of MgSO4 and bupivacaine improved postoperative pain scores, decreased analgesic requirements, and reduced consumption of rescue analgesics compared to both intraperitoneal instillation of sole bupivacaine and bupivacaine–tramadol combination.
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spelling doaj-art-ccf9a891e9bf401b856cf5ba92157dea2025-01-25T09:57:50ZengWolters Kluwer Medknow PublicationsBali Journal of Anesthesiology2549-22762024-04-018211011410.4103/bjoa.bjoa_34_24Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trialSantosh Kumar SahuPrerna BiswalMadhusmita PatroSushree DasAbstract Background: The use of intraperitoneally administered local anesthetics as a sole agent or in combination with various types of analgesics has been used increasingly recently. The goal of this study was to compare the effects of intraperitoneal bupivacaine, bupivacaine with magnesium sulfate, and bupivacaine with tramadol for postoperative analgesia in laparoscopic cholecystectomy. Materials and Methods: We carried out this prospective, double-blind, randomized trial in 90 patients aged between 20 and 60 years who were randomly divided into three groups. Group B received 25 mL (0.25%) bupivacaine, group T received 25 mL (0.25%) bupivacaine and 100 mg tramadol, and group M received 25 mL of 0.25% bupivacaine and 50 mg/kg of MgSO4. All drugs were administered by intraperitoneal instillation. The Visual Analog Scale (VAS), time of first rescue analgesia, and total dose of rescue analgesia were compared. Results: VAS was significantly higher in group B than in group M at all observed times. The significance also showed when comparing VAS between groups M and T at 4 h (P < 0.001), 6 h (P < 0.001), 12 h (P = 0.001), and 24 h (P < 0.001) postoperatively. Group M showed the longest time to rescue analgesia (22.57 ± 0.97 h, P < 0.001) and the lowest dose requirement of rescue analgesia (P < 0.001). Furthermore, the incidence of postoperative nausea and vomiting was comparable (5 vs. 1 vs. 5, respectively, P = 0.191). Conclusion: Intraperitoneal instillation of MgSO4 and bupivacaine improved postoperative pain scores, decreased analgesic requirements, and reduced consumption of rescue analgesics compared to both intraperitoneal instillation of sole bupivacaine and bupivacaine–tramadol combination.https://doi.org/10.4103/bjoa.bjoa_34_24cholecystectomylaparoscopylocal anesthesiapainpostoperative
spellingShingle Santosh Kumar Sahu
Prerna Biswal
Madhusmita Patro
Sushree Das
Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial
Bali Journal of Anesthesiology
cholecystectomy
laparoscopy
local anesthesia
pain
postoperative
title Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial
title_full Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial
title_fullStr Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial
title_full_unstemmed Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial
title_short Peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy: A prospective, double-blind, randomized clinical trial
title_sort peritoneal instillation of magnesium sulfate and bupivacaine improves postoperative pain in laparoscopic cholecystectomy a prospective double blind randomized clinical trial
topic cholecystectomy
laparoscopy
local anesthesia
pain
postoperative
url https://doi.org/10.4103/bjoa.bjoa_34_24
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