Comparison of Intraperitoneal Instillation of 20ml of 0.25% Ropivacaine with 20ml of 0.5% Ropivacaine for Post-Operative Analgesia in Laproscopic Cholecystectomy

Abstract

Background: Postoperative pain remains a concern after laparoscopic cholecystectomy. This study compared the analgesic efficacy of intraperitoneal 0.25% and 0.5% ropivacaine.

Methods: Forty ASA I–II patients aged 20–50 years undergoing elective laparoscopic cholecystectomy were randomized into two groups. Group A received 20 mL of 0.25% ropivacaine, while Group B received 20 mL of 0.5% ropivacaine intraperitoneally. Postoperative VAS scores, time to first rescue analgesia, total analgesic consumption, haemodynamic parameters, and adverse effects were assessed over 24 hours.

Results: Baseline characteristics were comparable. VAS scores were significantly lower in Group B up to 12 hours, while the difference at 24 hours was not significant. Time to first rescue analgesia was longer in Group B (6.1 ± 1.7 versus 3.8 ± 1.2 hours; p<0.001), and 24-hour diclofenac consumption was lower (78.8 ± 51.7 versus 138.8 ± 56.3 mg; p=0.001). Haemodynamic parameters and adverse effects were comparable.

Conclusion: Intraperitoneal instillation of 20 mL of 0.5% ropivacaine provided better early postoperative analgesia and reduced rescue-analgesic requirements compared with 0.25% ropivacaine.