الفهرس 
ANATOMY OF BILIARY TRACTOnly 14 pages are availabe for public view
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Abstract
Laparoscopic Cholecystectomy among the most frequently
performed elective daycare surgeries. After laparoscopic
cholecystectomy shoulder and abdominal pain causes
considerable distress.
To determine the efficacy of intraperitoneal bupivacaine
instillation on management of early postoperative pain in
patient undergoing laparoscopic cholecystectomy
This is a prospective randomized study with sample size
of 50 patients underwent elective laparoscopic cholecystectomy.
We recruited patients from surgery department at Agouza
Hospital. We randomly assigned patients to undergo
laparoscopic cholecystectomy with bupivacaine and 25 ml of
physiological saline (0.9% normal saline) on liver bed or
without bupivacaine.
Patients were subjected to detailed history taking and
clinical examination. Our primary outcomes were visual analog
scale (VAS) and verbal rating scale (VRS) at 2, 12 and 24hr
postoperative. Our secondary outcomes include length of
hospital and intensive care unit stay, need of additional
analgesic and the incidence of nausea and vomiting
Fifty patients finally met our inclusion criteria. In
bupivacaine group, mean age was 35 (± 6.6), 64% were females
and 36% were males. While in non-bupivacaine group mean
age was 37.6 (± 6.6), 68% were females and 32% were males
with no statistically significant difference between both groups;
age (P value=0.22) and age (P value=0.77).
In bupivacaine group there was significant pain reduction
compared to non-bupivacaine group in terms of VAS at 2 h (p
value=0.04), 12 h (p value=0.02), 24 h (, p value=0.01) and
VRS at 2 h (p value<0.01), 12 h (p value<0.01), 24 h (p
value<0.01). Hospital stay was lower hospital stay in
bupivacaine group 0.94 (± 0.16) than non-bupivacaine group
1.21 (± 0.41) (p value<0.01). Need for additional analgesia was
lower in bupivacaine group (P value <0.01).
There was no significant difference between both groups
regarding surgery duration (p =0.57), incidence of nausea (P
value= 0.09) and vomiting (P value= 0.31).