Evaluation of intraperitoneal levobupivacaine with and without sufentanil for postoperative analgesia after laparoscopic cholecystectomy

Abstract

Background and objectives Postoperative pain after laparoscopic cholecystectomy (LC) is unpredictable, which explains the need for systematic prevention of pain before the patient wakes up from anesthesia. The study was conducted to evaluate the effect of intraperitoneal levobupivacaine with or without sufentanil for postoperative analgesia after LC. Patients and methods Ninety patients who underwent elective LC completed the study. Group C (n=29) received 50 ml of intraperitoneal normal saline, group L (n=31) received 50 ml of intraperitoneal levobupivacaine 0.25%, and group LS (n=30) received 50 ml of intraperitoneal levobupivacaine 0.25% plus 20 μg sufentanil. Visual analog score was recorded immediately postoperatively, and at 4, 8, and 12 h postoperatively. In addition, time to first rescue analgesia (diclofenac), total diclofenac consumption in 12 h, and complications (pruritus, emesis, shoulder pain, bradycardia, and hypotension) were recorded. Results Visual analog score until 8 h postoperatively was significantly higher in group C compared with groups L and LS. However, the difference was nonsignificant between groups L and LS, except at 8 and 12 h postoperatively. Time to first rescue analgesia was significantly longer in group LS (134.16±36.5) compared with group C (11.96±5.92) and group L (114.83±35.49) (P<0.001). Total diclofenac consumption in the first 12 h postoperatively was significantly lower in group L (92.5±32.26) and group LS (82.5±22.88) compared with group C (152.5±13.69). Conclusion Intraperitoneal instillation of levobupivacaine with sufentanil reduces not only the intensity of postoperative pain but also the total rescue analgesic dose consumption after LC.