Effectiveness of the Intraperitoneal Irrigation using Sodium Bicarbonate on Postoperative Pain Severity after Midline Laparotomy

Abstract

Background and Objectives: Sodium bicarbonate may be effective in reducing the pain since it creates an alkaloid environment and prevents acidosis. Therefore, this study aimed to investigate the effect of intraperitoneal irrigation using sodium bicarbonate on postoperative pain severity. Methods: This non-randomized, double-blind clinical trial was performed on 50 candidates for elective surgery with midline laparotomy at Besat Hospital in Hamadan, Iran, during 2017-18. The patients were assigned into an intervention (underwent intraperitoneal irrigation using sodium bicarbonate solution) and a control group (underwent intraperitoneal irrigation using the normal saline solution). The severity of the pain 12 and 24 h after the surgery in patients was measured using a Visual Analog Scale (VAS). Results: The mean ages of the patients were 48.87±11.68 and 49.56±15.44 years in the intervention and control groups, respectively. Regarding gender distribution, 52% of the participants were male. Moreover, the mean pain scores 12 h after the surgery were 6±1.71 and 7.56±1.47 in the intervention and control groups, respectively. Additionally, the mean pain scores obtained from VAS 24h after the surgery were 20.20±1.15 and 3.68±1.62 in the intervention and control groups, respectively. According to the results, the mean score of pain was significantly lower in the intervention group, compared to the control group (P<0.05). However, there was no significant difference between the two groups regarding the frequency of complications and the amount of opioid consumption. Conclusion: The combination of sodium bicarbonate and normal saline solution for intraperitoneal irrigation is a simple method with no complication. This can help reduce postoperative pain up to 24 h after surgery.

Keywords

• laparotomy
• pain
• sodium bicarbonate
• surgery.