Effect of incisional and intraperitoneal bupivacaine on postoperative pain in laparoscopic cholecystectomy [Laparoskopi̇k kolesi̇stektomi̇ operasyonlarinda i̇nsi̇zyonel ve i̇ntraperi̇toneal bupi̇vakai̇ni̇n postoperati̇f aǧri üzeri̇ne etki̇si̇]

Objective: in this study,we aimed to compare the effects of local infiltration in incision sites and intraperitoneal administration of two different doses of 0.25% bupivacaine over postoperative pain scores,analgesic and antiemetic requirements at the end of laparoscopic cholesystectomy operations. method: after receiving ethic committee approval and consent,asa i-ii,30 patients between the ages of 25-70 were randomly divided into two groups. anesthesia was induced with fentanyl,propofol,rocuronium and general anesthesia was maintained with remifentanyl and sevoflurane in both groups. in both groups,before closing the peritoneum by the surgical team,20 ml of 0.25% bupivacaine was infiltrated to the four trocar sites (5 ml to each site). in addition,bupivacaine 20 ml in group i,bupivacaine 40 ml in group ii were administered to gallbladder bed. during the first 24 hours,vas at rest and during coughing,the number of patients requiring analgesic and antiemetic,right shoulder pain,adverse effects and patient satisfaction were recorded. results: during the rest at postoperative 12th hour,vas scores in group ii were significantly lower than group i (p> 0.05). between the groups,vas scores during coughing,analgesic and antiemetic requirements,number of patients with right shoulder pain,patient satisfaction scores and side effects were not different (p> 0.05). conclusion: in the elective laparoscopic cholecystectomy surgery,application of incisional 20 ml and intraperitoneal 40 ml bupivacaine 0.25% is more effective than the application of incisionel 20 ml and intraperitoneal 20 ml bupivacaine 0.25% at the end of the operation.