Original Articles
Comparison of Ropivacaine and Levo-bupivacaine instilled intra-abdominally during laparoscopic surgery for acute appendicitis | |
Dr. Hemant Kumar Khowal, Dr. Ashutosh Kumar | |
Background: Pain, nausea, vomiting, chest infections, and DVT risks are postoperative issues associated with abdominal surgery. These issues cause delayed ambulation, higher morbidity, and longer hospital stays, all of which raise health care expenditures. The present study was conducted to compare Ropivacaine and Levo-bupivacaine instilled intra-abdominally during laparoscopic surgery for acute appendicitis. Materials & Methods: 90 patients classed as ASA I and II with acute appendicitis of both genderswere divided into 3 groups of 30 each. Group I, the placebo group, received 50 mls of 0.9% saline, Group II received 50 mls, (0.75% Ropivacaine plus 0.9% saline) at a dose of 3 mg/kg and Group III received 50 mls, (0.5% Levo-bupivacaine plus 0.9% saline) at a dose of 2 mg/kg. Parameters such as amount of PCA morphine used, and side effects were noted. Results: Group I had 15 males and 15 females, group II had 16 males and 14 females and group III had 17 males and 13 females. The mean morphine used in group I was 24.5 mg/ml, in group II was 11.9 mg/ml and in group III was 11.2 mg/ml. The difference was significant (P< 0.05). Nausea/ vomiting was seen in 5 in group I and 1 each in group II and III. Headache was seen in 3 in group I and 2 patients in group III. The difference was significant (P< 0.05). Conclusion: Although some studies have suggested that Ropivacaine is less effective than Bupivacaine, there doesn't seem to be any difference between the two medications in terms of pain alleviation. For laparoscopic surgery, it is advantageous to administer a local anesthetic beforehand to reduce post-operative pain. |
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