A COMPARISON OF POST-OPERATIVE PAIN RELIEF AFTER ELECTIVE LSCS WITH LOCAL AND INTRAPERITONEAL ROPIVACAINE INSTILLATION AGAINST LOCAL ROPIVACAINE INFILTRATION ALONE

SONALI TRIPATHI; SANDEEP THAKRE; NIDHI NARREY; DILEEP DANDOTIYA; PUJA SINGH; AMIT KUMAR JAIN

doi:10.22159/ajpcr.2023.v16i4.47694

Authors

SONALI TRIPATHI Department of Anaesthesiology, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
SANDEEP THAKRE Department of General Surgery, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
NIDHI NARREY Department of Obstetrics and Gynecology, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
DILEEP DANDOTIYA Department of Community Medicine, Chhindwara Institute of Medical Sciences, Chhindwara, Madhya Pradesh, India.
PUJA SINGH Department of Pathology, Bundelkhand Medical College, Sagar, Madhya Pradesh, India.
AMIT KUMAR JAIN Department of Anaesthesiology, SSH, NSCB Medical College, Jabalpur, Madhya Pradesh, India.

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i4.47694

Keywords:

Spinal anesthesia, Ropivacaine, Local infiltration, Intraperitoneal instillation

Abstract

Objectives: For an anesthesiologist, the post-operative phase is just as crucial as the pre-operative and intraoperative periods. Whether a surgery is performed under regional or general anesthesia, the goal should always be to provide patients with a pain-free and comfortable recovery. Spinal anesthesia is frequently used during caesarean sections, but its effects only last for a few hours. As a result, various multidisciplinary analgesia strategies with few side effects have been attempted for postpartum patients to relieve pain because they may also be harmful to the newborn baby’s health. It has already been proven; injecting ropivacaine is a far safer alternative to injecting bupivacaine. We compared local infiltration of injectable ropivacaine alone to both intraperitoneal instillation and local infiltration for post-operative analgesia in individuals who had cesarean surgery. In the present study, intraperitoneal instillation and local infiltration of ropivacaine 0.5% were compared to local infiltration of ropivacaine 0.5% alone for the management of post-operative pain following elective cesarean section under spinal anesthesia.

Methods: Pregnant women in ASA Grades I and II who were having a planned caesarean section under spinal anesthesia were divided into two groups at random (R1 and R2 group, each have 30 patients). Patients in Group R1 received a 15 mL injection of 0.5% ropivacaine at the incision site. Patients in Group R2 had intraperitoneal injections of 0.5% ropivacaine in 5 mL before to peritoneal closure and local infiltrations of 10 mL ropivacaine at the site of the incision before skin closure. The duration of the analgesia was calculated by timing the start of the sensory block to a point at which rescue analgesia was sought throughout the post-operative period. Pain intensity was measured using the visual analog scale (VAS). Data on the hemodynamics and side effects of the patients were also gathered.

Results: Group R2 analgesia lasted much longer than that of Group R1 (p<0.05). The mean (±SD) analgesic duration in the R1 and R2 groups was 147.17±4.67 and 170.33±3.69 min, respectively. The mean (SD) VAS scores for Group R1 and Group R2 at the moment of the first analgesic demand were 36.7±5.14 and 32.6±6.52, respectively.

Conclusion: When combined with intraperitoneal instillation during spinal anesthesia, inj. ropivacaine 0.5% local infiltration enhances post-operative analgesia in cesarean section procedures.

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