Résumé
Background: The improved understanding of origin of abdominal and shoulder pain after laparoscopic procedures led to the use of intra peritoneal and port site instillation of local anaesthetic to reduce post-operative pain. Combinations of intraperitoneal local anaesthetics with many opioids have been studied in past and it was proved that they provide additional analgesic benefits. Material and methods: 106 ASA grade I and II patients of age 20 to 60 years of either sex weighing 40 to 70 kg undergoing laparascopic cholecystectomy under general anaesthesia were enrolled for the present study after written informed consent and institutional ethical committee cleareance. Patients were randomized into two groups , Group I (n=53): Patients received 30ml of 0.5% ropivacaine with 2ml Normal Saline. Group II (n=53): Patients received 30ml of 0.5% ropivacaine with fentanyl 100 mcg (2 ml). General anaesthesia was standardized. VAS, VRS scores, hemodynamics, total amount of rescue analgesic and side effects were noted at regular intervals. Results: VAS and VRS score were significantly lower in ropivacaine plus fentanyl group in comparisons to ropivacaine alone group at most of the time intervals. Hemodynamics was comparable between the two groups. Total Rescue analgesic were also significantly ow in ropivacaine plus fentanyl group side effects were comparable between two group. Conclusion: Intraperitoneal instillation of ropivacaine with fentanyl reduces not only the intensity of visceral, parietal and shoulder pain but also the total rescue analgesic dose consumption.