Browsing by Author "Yadav, Vimal Kumar"
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Publication Analgesic Efficacy of Intraincisional and Intraperitoneal Bupivacaineversus Ropivacaine in Laparoscopic Cholecystectomy in a TertiaryCare Hospital: A Prospective Observational Study(Nepal APF Hospital, 2026) Yadav, Vimal Kumar; Dhittal, Saroj Prasad; Deo, Kishor KumarAbstract: Introduction: Laparoscopic Cholecystectomy is established as the standard treatment in cases of symptomatic cholelithiasis and chronic cholecystitis. Adequate postoperative pain management has favorable outcomes for the patients. Port site and intraperitoneal instillation of local anesthetics have shown good results. The aim of this study was to compare the analgesic effects of bupivacaine and ropivacaine in postoperative pain relief following laparoscopic cholecystectomy. Methods: An observational study was conducted among 60 patients who underwent elective Laparoscopic Cholecystectomy in a tertiary care hospital from August 2020 to January 2021, following ethical approval from the Institutional Review Board (IRB Ref No. 449/2077/78). The patients received intraincisional (10 ml) and intraperitoneal (10 ml) infiltration of 25% bupivacaine or 25% ropivacaine. The pain was evaluated via a 100 mm Visual Analogue Scale. Statistical analysis was performed using independent sample t-test, Mann-Whitney U test, and Chi-square test and analyzed using the Statistical Package for the Social Sciences version 23. Point estimate at 95% Confidence Interval was calculated along with frequency and percentages for binary data and mean and standard deviation for continuous data. Results: The mean duration of surgery was 90.58±10.67 minutes. Out of total patients, the ropivacaine group had significantly lower Visual Analogue Scale at 1 hour and 6 hours compared to the bupivacaine group (p= 0.028 and p= 0.007, respectively). The ropivacaine group had a significantly longer mean time to first rescue analgesia (203±40.52 minutes) than bupivacaine group (141.50±43.80 minutes) (p= 0.001). The total amount of pethidine consumption after 24 hours was significantly less in ropivacaine group (30 mg) than bupivacaine group (70 mg; p <0.001). Conclusions: Ropivacaine provided superior analgesia with lower pain scores, prolonged analgesic duration, and reduced opioid requirements following cholecystectomy compared to bupivacaine, while both agents were realtively safe.