복강내 도포된 0.5% Bupivacaine은 복강경하 담낭절제술후의 통증을 감소시킨다

• Published in: Korean journal of anesthesiology Vol. 33; no. 7; pp. 1103 - 1108
• Main Authors: 석미자, Mi Ja Seouk, 황승옥, Seung Ok Hwang, 이관우, Gwan Woo Lee, 강봉진, Bong Jin Kang, 김석곤, Seok Kon Kim, 김태진, Tae Jin Kim
• Format: Journal Article
• Language: Korean
• Published: 대한마취통증의학회(구 대한마취과학회) 01.01.1997
• Subjects: Anesthetics; bupivacaine. Anesthetic Technique; laparoscopic cholecystectomy; local; postoperative. Surgery; topical. Pain
• ISSN: 2005-6419; 2005-7563

Background : Recently, laparoscopic cholecystectomy becomes more favorite method than traditional open cholecystectomy. But postoperative pain control is still remaining problem. Method : Patients scheduled for elective laparoscopic cholecystectomy were assigned to two groups by simple randomization(15 patients per group). Group C(control) had no specific treatment and group B(bupivacaine) received 20 ml of 0.5% bupivacaine with epinephrine 1:200,000 before surgery. Immediately after the creation of a pneumoperitoneum, the surgeon sprayed the bupivacaine near and above the operation field. Operation was started 10 minutes after then. We attempted to investigate that the degree of postoperative pain which was assessed using the visual analogue scale(VAS) and the verbal rating scale(VRS) in the recovery room at postoperative 1 h., as well as the analgesic requirements during the first 24 h. postoperatively. Result : VRS of group B was significantly lower than group C(p＜0.05), but VAS was not significantly different. Six patients in group B and only one in group C requested no analgesics. Group C had statistically more frequent request for analgesics than group B(p＜0.05). Conclusion : The topical intraperitoneal anesthesia of 20 ml of 0.5% bupivacaine with epinephrine 1 : 200,000 before laparoscopic cholecystectomy is effective on the postoperative pain control. So, we recommmend that this simple and effective management is routinely treated in patients undergoing laparoscopic cholecystectomy. (Korean J Anesthesiol 1997; 33: 1103∼1108)