Comparing the Efficacy of Intraperitoneal Bupivacaine-Tramadol and Bupivacaine-Magnesium Sulfate for Pain Management After Laparoscopic Cholecystectomy

Abstract

Background: The use of local anesthetics, administered intraperitoneally, either alone or in combination with other medications, after laparoscopic cholecystectomy has gained popularity as a method to reduce postoperative pain. This approach involves introducing local anesthetic agents into the peritoneal cavity during the surgery to provide pain relief in the postoperative period. Methods: In a prospective, randomised, double-blind study, we enrolled 100 patients aged between 20 to 45 years who were scheduled for laparoscopic cholecystectomy and had ASA grade 1 or 2. These patients were randomly allocated into two groups, Group BT and Group BM. Group BT received 0.25% bupivacaine 30 ml along with 100 mg tramadol, while Group BM received 0.25% bupivacaine 30 ml combined with 50 mg of MgSO4. We assessed and compared various parameters, including the analgesic efficacy, duration of pain relief, and any associated side effects.Results: In our study, we observed a higher number of female participants than male participants, although this gender difference was not statistically significant (P > 0.05). Regarding the duration of anesthesia, we did not identify any statistically significant difference between the two groups (P > 0.05). However, when assessing postoperative pain relief, we noted that the BM group experienced 1 to 2 hours more relief compared to the BT group, and this difference was statistically significant. In terms of side effects, we observed no significant occurrences in either group except for nausea and vomiting in two patients from the BT group. Nonetheless, this difference was not statistically significant (P > 0.05).Conclusion: The intraperitoneal instillation of a Bupivacaine-MgS04 combination appears to offer effective analgesia during the first 24 hours after surgery. It provides a longer pain-free period when compared to the Bupivacaine-Tramadol combination. This suggests that the Bupivacaine- MgS04 combination may be a more suitable option for postoperative pain management in patients undergoing laparoscopic cholecystectomy.