Somnath Dey1, Swarup Dutta2, Debarati Goswami3, Aditya Prasad Sarkar4, Suman Chatterjee5, Purnendu Dash6
BACKGROUND
Postoperative
pain after open cholecystectomy is associated with respiratory dysfunction, increased stress response and
prolonged hospital stay. We compare intravenous paracetamol (7.5 mg/kg) plus intercostal nerve block with local anaesthetic
ropivacaine 0.5% to intravenous paracetamol (15 mg/kg) on pain control after open cholecystectomy.
MATERIALS AND METHODS
140
patients, who underwent for open cholecystectomy, were randomly divided into two groups of 70. The patients were
randomly allocated to any of the following two groups depending upon the drug used for analgesia (Group P or Group I)
Intravenous paracetamol 15 mg/kg was given to patients of group P and paracetamol 7.5 mg/kg with Intercostal nerve block in
right side 6 10 intercostal nerves with 2 ml local anaesthetic ropivacaine 0.5% in each space was given to patients of group I
just after intubation before incision. When the patients were transferred to postoperative recovery room, intensity of pain was
recorded by response from the patients using 100 mm linear visual analogue scale ranging from 0 to 100. The pain scoring was
done in the immediate postoperative period (when the patient was able to communicate in the post anaesthesia care unit), at
30 minutes, 1 hr. then hourly up to 24 hrs till patient complained of pain with VAS score 40 or more.
RESULTS
The
severity of pain in VAS score was lower in immediate post operative period, at 30 minutes, 1 hour and 2 hours postoperatively
in group I than the group P and those were statistically significant (p< Duration of analgesia also significantly lower in
group I. Mean duration of analgesia in group P is 161.9 42.6 min and in group I is 241.3 44.2 min (p<
CONCLUSION
Adding
Intercostal nerve block to intravenous infusion of Paracetamol infusion (7.5 mg/kg) is better than sole intravenous
infusion of Paracetamol (15 mg/kg) in controlling pain severity even after reducing dose of paracetamol after open
cholecystectomy.
