Dr Iffat Sharmin, Resident, Department of Surgery, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh; E-mail:
Mymensingh Med J. 2023 Oct;32(4):1133-1139.
Pain management is an essential component of all surgical procedures. Analgesics are used for this purpose but there are some complications in using them. Local anesthetics like bupivacaine can be used to reduce postoperative pain as well as analgesics consumption. The objective of this study is to observe the result of infiltration of bupivacaine at port sites and to compare the postoperative pain relief with that of opioids and NSAID administration following laparoscopic cholecystectomy for chronic calculus cholecystitis. This is a cross sectional study was conducted over one year in the Department of Surgery of Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh from September 2018 to August 2019. Here total 40 patients were enrolled by purposive sampling. They were divided in two groups. One group received bupivacaine while other did not. A numerical pain scale was used as tool. Data will be recorded by peer reviewed interview and observation based semi structured data collection sheet. Data analysis was done by SPSS version 23.0. P-value was significant at (p<0.05) and determined by chi square test. Written informed consent was taken from the patient. The mean Numerical Rating Scale (NRS) score of pain at 6 hour was 2.55±0.6 in Group I and 6.8±1.15 in Group II. The mean NRS score of pain at 12 hour was 4.1±1.21 in Group I and 7.95±0.6 in Group II. The mean time of 1st analgesic administration was 13.85±1.57 hours in Group I and 2.75±0.72 hours in Group II. The mean repeat dose of analgesic was in 22±2.29 hours in Group I and 9.5±1.15 hours in Group II. In Group I one third patients (30.0%) single dose analgesic required in 1st 12 hours while in Group II almost 90.0% patients needed analgesics in 1st 12 hours. In Group I, total doses of analgesics required were 2 in 75.0% patients while in Group II at least 3 doses of analgesics were needed. In Group I only one patient needed analgesic in first 6 hours (5.0%) while in Group II, all the patients (100.0%) needed analgesics. The difference was statistically significant (p<0.05) between two groups. The patients receiving bupivacaine at port sites will experience less pain at postoperative period and will need less analgesic medications.
疼痛管理是所有外科手术的重要组成部分。为此使用了镇痛药，但使用它们存在一些并发症。局部麻醉剂如布比卡因可用于减轻术后疼痛和减少镇痛药的消耗。本研究的目的是观察布比卡因在端口部位的浸润效果，并比较其与阿片类药物和 NSAID 给药在慢性结石性胆囊炎腹腔镜胆囊切除术后的术后疼痛缓解效果。这是一项在孟加拉国达卡的 Bangabandhu Sheikh Mujib 医科大学（BSMMU）外科系进行的为期一年的横断面研究，时间为 2018 年 9 月至 2019 年 8 月。共纳入 40 名患者，采用目的性抽样。他们被分为两组。一组接受布比卡因，另一组不接受。使用数字疼痛量表作为工具。通过同行评议访谈和基于半结构化数据收集表的观察记录数据。使用 SPSS 版本 23.0 进行数据分析。P 值具有统计学意义（p<0.05），由卡方检验确定。患者签署了书面知情同意书。第 I 组在 6 小时时的平均数字评定量表（NRS）疼痛评分是 2.55±0.6，第 II 组是 6.8±1.15。第 I 组在 12 小时时的平均 NRS 疼痛评分是 4.1±1.21，第 II 组是 7.95±0.6。第 I 组第 1 次镇痛给药的平均时间是 13.85±1.57 小时，第 II 组是 2.75±0.72 小时。第 I 组第 1 次镇痛的平均重复剂量是 22±2.29 小时，第 II 组是 9.5±1.15 小时。第 I 组中有三分之一的患者（30.0%）在第 1 个 12 小时内仅需单次剂量的镇痛药，而第 II 组中有近 90.0%的患者在第 1 个 12 小时内需要镇痛药。第 I 组中，75.0%的患者需要 2 剂镇痛剂，而第 II 组中至少需要 3 剂镇痛剂。第 I 组中仅 1 名患者（5.0%）在第 1 个 6 小时内需要镇痛剂，而第 II 组中所有患者（100.0%）都需要镇痛剂。两组之间的差异具有统计学意义（p<0.05）。在端口部位接受布比卡因的患者在术后期间将经历较少的疼痛，并将需要较少的镇痛药。
