“Comparison of preincisional port site infiltration of 0.5% levobupivacaine versus 0.5% ropivacaine for postoperative pain relief in patients undergoing laparoscopic appendicectomy: A one year hospital-based double-blind randomized controlled trial”

Abstract

Introduction: Administration of local anesthetic into the wound before incision has been found to reduce postoperative pain following laparoscopic surgery. Levobupivacaine and ropivacaine which are less cardiotoxic and neurotoxic than bupivacaine are being used for local infiltration. Objective: To compare the efficacy of preincisional port site infiltration of 0.5% levobupivacaine versus 0.5% ropivacaine for postoperative pain relief in patients undergoing laparoscopic appendicectomy. Methodology: By computer-generated randomization table, sixty adult patients undergoing elective laparoscopic appendicectomy under general anesthesia were divided into two groups. Group 1 patients received 14 mL of 0.5% levobupivacaine preincisional port site infiltration and Group 2 patients received 14 mL of 0.5% ropivacaine preincisional port site infiltration, 6 mL at the umbilical port, and 4 mL at each working port. In the postoperative period, anesthesia resident blinded to the drug used assessed for postoperative pain at 0, 1, 2, 3, 4, 5, 6, 10, 14, 18, and 24 h using visual analog scale (VAS) pain scale. If VAS >3 rescue analgesia in the form of injection tramadol 2 mg/kg intravenous (IV) was given. Time of first rescue analgesia as well as total opioid consumption at the end of 24 h was noted. Results: The mean VAS scores were comparable in both the groups at different time intervals postoperatively (P > 0.05). The total amount of rescue analgesic consumed over 24 h in the form of injection. Tramadol IV was 126 ± 14.76 in Group 1 and 122 ± 12.77 in Group 2 and was comparable (P = 0.641). Conclusion: Preincisional port site infiltration with both 0.5% levobupivacaine and 0.5% ropivacaine is equally effective in providing pain relief.

Keywords

• 0.5% levobupivacaine
• 0.5% ropivacaine
• laparoscopic appendicectomy
• postoperative pain
• preincisional port site infiltration