Evaluation of Post-operative Analgesic effect of Intraperitoneal Ropivacaine with or without Tramadol in Laparoscopic Cholecystectomy

Analgesia in Laparoscopic Cholecystectomy

Abstract

Background: Aim: To evaluate post-operative analgesic effect of intraperitoneal ropivacaine with or without tramadol in laparoscopic cholecystectomy. Subjects and Methods: A total of one hundred twelve adult patients age ranged 18-58 years of American Society of Anaesthesiologists physical status (ASA-PS) grade I/II planned for elective laparoscopic cholecystectomy were divided into 2 groups of 56 patients. Group I received 18 mL of 0.5% ropivacaine +2 mL of normal saline and group II received 18 mL of 0.5% ropivacaine IP with 100 mg (2 mL) tramadol. In all patients, the pain score was monitored using a numerical rating scale (NRS) every 30 min till 4 hours post operatively and then at 6 hours, 12 hours and 24 hours. Results: There were 36 males and 20 females in group I and 35 males and 21 females in group II. The mean weight in group I was 62.1 Kgs and in group II was 61.7 kgs. ASA grade I was seen in 30 in group I and 29 in group II and grade II in 26 in group I and 27 in group II. Duration of surgery was 74.3 minutes in group I and 75.2 minutes in group II. Patients needing rescue analgesia (Fentanyl) was 71% in group I and 45% in group II and total analgesic consumption was 1568.4 g in group I and 794.2 g in group II. A non- significant difference was seen (P> 0.05). The mean pain score was at 30 minutes was 2.65 and 2.45, at 1 hour was 2.50 and 2.40, at 2 hours was 1.98 and 1.95, 4 hours was 1.80 and 1.40, at 6 hours was 1.65 and 1.35, at 10 hours was 1.15 and 1.24 and at 12 hours was 1.10 and 1.15. A non- significant difference was seen (P> 0.05). Conclusion:  Ropivacaine in combination with tramadol found to be effective in reducing the post-operative pain and analgesic requirement in post-operative period as compared to ropivacaine without tramadol in patient undergoing in elective laparoscopic cholecystectomy.