Bupivacaine and hydrocortisone effect on post operative pain after Laparoscopic cholecystectomy in patients with chronic cholecysititis

Laparoscopic cholecystectomy is a procedure of choice for treatment of chronic cholecystitis. Intensity of pain following this procedure in the first 24 hours after surgery is very high and is intolerable for many patients. The aim of this study was comparison of bupivacaine and hydrocortisone topical instillation in gallbladder bed for pain relief after laparoscopic cholecystectomy in patient with chronic cholecystitis. This single blind clinical trial was done in patients who underwent laparoscopic cholecystectomy due to chronic cholecystitis in Ayatollah Kashani hospital of Shahre- Kord in 2017. Sampling of patients was convenient method. Patients were divided into three groups: A group: 100 mg hydrocortisone group: 20 mL of bupivacaine solution 0.5% and C group: 20 ml of normal saline without medication. Pain was measured using VAS scale in the recovery room and 6 and 18 hours after surgery and if VAS score was more than 5, patients received 30 mg pethidine Stat. In this study the mean VAS scale in the recovery room and 6 hours after surgery had not significant difference between the groups. But VAS scale of 18 hours after surgery had a significant difference among the three groups. So that the VAS scale in the hydrocortisone group lesser than the control group and bupivacaine 0.5% group (p =0.009). In general, during this study, all three groups, pain intensity was significantly reduced. The satisfaction of patients in the three groups were similar (p =0.969). Regarding amount of nausea after surgery, 26.7% of hydrocortisone group, 20% of bupivacaine group 0.5%, and 23.3% of control group had postoperative nausea (p =0.830). In all three groups no headaches were reported. In this study, postoperative pain intensity in all three groups during the third phase of the study was reduced. And the use of hydrocortisone in laparoscopic cholecystectomy reduced the pain intensity in 18 hours after surgery significantly compared with the control group and bupivacaine 0.5%.