Local versus systemic analgesia in pain management of post-laparoscopic cholecystectomy patients

Abstract

Objective: To compare the efficacy of Toradol and a combination of bupivacaine with Toradol for postoperative analgesia in patients who underwent laparoscopic cholecystectomy. Methodology: This interventional study was conducted in the Department of Surgery, KMU-IMS, DHQ Teaching KDA Kohat, from June 2024 to Dec 2024.Two hundred and twenty-four patients who underwent laparoscopic cholecystectomy were divided into group T (received injection Toradol 0.5mg/kg I/V) and group TB (received 30ml of 0.25% injection bupivacaine intraperitoneally along with intravenous 0.5mg/kg injection Toradol). Pain was recorded using VAS at 1, 2, and 4 hours postoperatively. Rescue analgesia was given in patients with a VAS score > 3 who were uncomfortable with pain. We used the chi-square test to compare effectiveness between the two groups. Results: Mean ages were 37.41±3.09 years and 38.96±2.64 years in group T and Group TB, respectively. Mean VAS was 4.47±1.36 and 1.38±0.56 in group T & TB, respectively. Rescue analgesia was given to 23.21% of patients in group T and 0.0% in group TB (p-value=0.0003). Toradol injection was effective in 76.78% of patients, while the combination of Toradol and bupivacaine was effective in 100.0% of patients (p-value=0.0001). Conclusions: The efficacy of Toradol with bupivacaine was high as compared to Toradol alone for postoperative pain control after laparoscopic cholecystectomy.