THE EFFECTIVENESS OF INTRAPERITONEAL HYDROCORTISONE ON POST-OPERATIVE PAIN IN LAPAROSCOPIC CHOLECYSTECTOMY

BACKGROUND Postoperative pain can increase the morbidity and prolong hospital stay after laparoscopic cholecystectomy. Intraperitoneal analgesia is a component of multimodal approach to postoperative analgesia which is being increasingly investigated. We wanted to compare the effect of intraperitoneal hydrocortisone with intraperitoneal bupivacaine with regard to pain relief after laparoscopic cholecystectomy. METHODS 30 patients who were given intraperitoneal Bupivacaine and 30 patients who were given intraperitoneal Hydrocortisone were included in the study. Patients were followed regarding postoperative abdominal and shoulder pain using VAS score based on a 010 scale at 2, 4, 8, 12 and 24 hours and analgesic requirements postoperatively. RESULTS Patients in the Bupivacaine group had significantly lower abdominal and shoulder VAS scores. Statistically significant difference in abdominal VAS score was noted at 4 hours and 8 hours (p=0.031) postoperatively. With respect to shoulder pain VAS score, a statistically significant difference was noted at 8 hours and 12 hours (p=0.031). Requirement of rescue analgesia was also less in Bupivacaine group. CONCLUSIONS Intraperitoneal administration of Hydrocortisone is not as effective as intraperitoneal Bupivacaine in decreasing pain and analgesic requirements after laparoscopic cholecystectomy.