Analgesic Effect of Ultrasound Guided Paravertebral Block in Laparoscopic Cholecystectomy

Abstract

Background: Laparoscopic cholecystectomy is the most commonly performed surgical procedure in an adult population. Though it’s a minimally invasive procedure, significant proportion of patients have severe postoperative pain. Pain following laparoscopic cholecystectomy is multifactorial and complex in nature. Several modalities have been used to manage this pain. Ultrasound guided bilateral paravertebral block is one of the emerging technique. We aimed to evaluate the analgesic effect of ultrasound guided bilateral paravertebral block in patient undergoing laparoscopic cholecystectomy.

Methods: This is a clinical prospective, observational study. Fifty two patients, aged 18-70 years, American society of anesthesiologist (ASA) classification I and II scheduled for elective laparoscopic cholecystectomy under general anesthesia were enrolled and divided in two groups.Group1, received general anesthesia and ultrasound guided bilateral paravertebral block with Ropivacaine 20 ml 0.25% in each side group2 received general anesthesia without any block. We observed intraoperative additional fentanyl requirement and time of first rescue analgesia.

Result: In group1, none of the patient required additional intraoperative analgesia where as in group 2, 15.38 % (4/26) required additional analgesic, (p=0.045).Time of first rescue analgesia was longer (161.26 ±138.98mins) in paravertebral block group than in control group (41.68±24.96 mins) p<0.001.

Conclusion: Preoperative ultrasound guided bilateral paravertebral block using ropivacaine for laparoscopic cholecystectomy is effective for decreasing the additional intraoperative analgesia requirement and prolongs the analgesia duration in postoperative period.