Clinical Trial of Intraperitoneal Administration of Ketamine Combined with Bupivacaine on Pain Status after Laparoscopic Cholecystectomy

Parvin Ziaei; Saeed Kargar; Mohammad Hossein  Dehghan; Farzan Madadizadeh; Hamid Reza Jamshidi

doi:10.18502/ssu.v30i11.11787

Parvin Ziaei Department of Anesthesia, Faculty of Paramedicine, Shahid Sadougi University of Medical, Yazd, Iran.
Saeed Kargar Department of Surgery, Faculty of Medicine, Shahid Sadoughi University of Medical, Yazd, Iran.
Mohammad Hossein Dehghan Department of Anesthesia, Faculty of Paramedicine, Shahid Sadougi University of Medical, Yazd, Iran.
Farzan Madadizadeh Department of Statistics and Epidemiology, School of Health, Shahid Sadoughi University of Medical Sciences, Yazd, Iran.
Hamid Reza Jamshidi Department of Pharmacology and Toxicology, Faculty of Pharmacy, Shahid Sadougi University of Medical Sciences, Yazd, Iran

DOI: https://doi.org/10.18502/ssu.v30i11.11787

Keywords: Laparoscopic cholecystectomy, Shoulder pain, Intraperitoneal, Ketamine, Bupivacaine.

Abstract

Introduction: One of the most important problems that the patient faces after laparoscopic surgery is pain that is felt in the shoulders, back and abdomen. This study was designed to evaluate the effects of the combination of bupivacaine and ketamine and its intraperitoneal injection on reducing shoulder pain after laparoscopic cholecystectomy.

Methods: This was a double-blind randomized study that included 90 patients undergoing elective surgery for laparoscopic cholecystectomy in the age group of 18-65 years and of both sexes. After removal of the gallbladder, 20 cc of solution was injected intraperitoneally at the surgical site. Patients were randomly assigned to three groups receiving 10 cc 0.5% bupivacaine + 0.5cc ketamine, the second group received 10 cc of %0.5 bupivacaine and 10 cc normal saline, the third group (control) received 20 cc of normal saline intraperitoneally. The findings were analyzed using SPSS version 16 software and repeated measurement analysis of variance and Bonferroni's pairwise comparison test.

Results: Analysis of variance showed that the mean pain scores were significantly different over time in each group (P<0.001). (P<0.001). Bonferroni paired comparison test showed that the lowest amount of pain was in the first group (p<0.05).

Conclusion: According to the results of the present study, intraperitoneal injection of ketamine combined with bupivacaine significantly (p<0.001) reduces pain up to 8 hours after laparoscopic cholecystectomy.