Akademik Veri Yönetim Sistemi
Turk Anesteziyoloji ve Reanimasyon, cilt.29, sa.6, ss.281-284, 2001 (Scopus)
Local anaesthetic and opioid combination techniques have been studied extensively intrathecally to relieve postoperative pain. Howewer, it has not been assessed intraperitoneal in patients undergoing laparoscopic cholecystectomy. Our hypothesis was that the addition of intraperitoneal morphine improves bupivacaine analgesia in laparoscopic cholecystectomy. 48 patients scheduled for laparoscopic cholecystectomy were randomly assigned in a double blind manner to one of three groups. Group I (n=16) received 200 mL salin, Group II (n=16) received 20 mL 0.25% bupivacaine with epinephrine (200 000 dilution) in 200 mL salin, Group III (n=16) received 20 mL 0.25% bupivacaine with epineprine (200 000 dilution) and 30 mg morphine in 200 mL salin. All test solutions was given immediately after pneumoperitoneum and it was sprayed intraperitoneally into the glad bladder and into the subphrenic surface of liver under direct vision. Postoperative pain was assessed using VAS (visual analog scale) and VRS (verbal rating scale) at 1, 2, 4, 8, 12, 24 and 48 hours after laparoscopic cholecystectomy. Visual analog scale and verbal rating scale values were significantly less in the Group III compared with Group I and Group II (p<0.01). In the Group II, the pain intensity was significantly lower than in the Group I (p<0.01). The intraperitoneal administration of bupivacaine provides pain relief in patients undergoing laparoscopic cholecystectomy. The combined intraperitoneal administration of bupivacaine and morphine is superior to only intraperitoneal bupivacaine.