Intraperitoneal instillation of lornoxicam–levobupivacaine versus tramadol–levobupivacaine in patients undergoing laparoscopic cholecystectomy under general anesthesia

• Published in: Research and Opinion in Anesthesia & Intensive Care 2019-04, Vol.6 (2), p.228-233
• Main Authors: Hayes, Salwa, Hefnawy, Emad El, Askar, Waleed, Suliman, Lucy
• Format: Article
• Language: English
• Subjects: Analgesia; Analgesics; Anesthesia; Atracurium; Blood pressure; Bupivacaine; Cholecystectomy; Combination drug therapy; Comparative analysis; Complications and side effects; Dexmedetomidine; Dosage and administration; Heart rate; Laparoscopy; Local anesthesia; Methods; Narcotics; Nonsteroidal anti-inflammatory agents; Pain management; Patients; Postoperative pain; Prevention; Quality; Risk factors; Surgery; Tramadol
• ISSN: 2356-9115; 2356-9123
• DOI: 10.4103/roaic.roaic_12_19

Background Intraperitoneal local anesthetic administration is used for reducing postoperative pain after laparoscopic surgery, this study aimed to compare intraperitoneal instillation of lornoxicam–levobupivacaine versus tramadol–levobupivacaine on the quality of postoperative analgesia for elective laparoscopic cholecystectomy. Patients and methods After ethical approval, 90 (30/group) patients scheduled for elective laparoscopic cholecystectomy were randomly allocated to receive intraperitoneal instillation of either 25 ml of normal saline for patients in group S, 20 ml of levobupivacaine 0.5% combined with 5 ml of lornoxicam (16 mg) for patients in group L or to receive 20 ml of levobupivacaine 0.5% combined with 5 ml of tramadol (100 mg) for patients in group T. Postoperative pain-free period, visual analog pain scores, pulmonary functions and cumulative fentanyl consumption were recorded. Results Postoperative pain-free period showed significantly longer duration in group L and group T in comparison to group S with 6.86 h in group L and 6.90 h in group T versus 1.33 h in group S at 95% confidence interval, also total fentanyl consumption decreased in group L and group T in comparison to group S. Pulmonary functions were decreased in all groups but with less decrease in group L and group T in comparison to group S. Conclusion Addition of either lornoxicam or tramadol provided safe, effective, less affection of pulmonary functions and good quality of analgesia when added to levobupivacaine without any significant differences between both groups for intraperitoneal administration.