Postoperative Morphine Requirement in Cholecystectomy with Interpleural Injection of Bupivacaine

Upper abdominal and thoracic surgery contributes most of surgical operations. Sever postoperative pain deteriorates respiratory functions and leads to complications such as hypoventilation and atelectasis. If an interpleural nerve block reduces respiratory complications, it will reduce analgesic drugs in take, hospitalization period and costs.

The main goal of this study was comparison of Morphine requirement in patients who under went Cholecystectomy.

In this double blind study patients were divided into two groups equally, each group had 72 patients. First group received placebo, and 2nd received Bupivacaine 0.5 percent. The solution was injected by a surgeon via surgical incision into pleural cavity at the end of procedure. After injection, patients were monitored during the next 24 hours due to pain and Morphine requiring.

The average of Morphine dosage which was injected after surgery in placebo group was 7.86±0.26 mg and in case group was 5.50± 0.50 mg(p<0.01). In placebo group about 83 percent and in case group about 19 percent of patients received Morphine (p<0.0001). In placebo group the average time between end of surgery and the first injection of Morphine was 4.33± 0.27 hr and in case group was 7.64 ± 0.96 hr (p<0.01).

We can conclude that in case group analgesic requirements were reduced and duration between end of surgery and first dose of injection was prolonged. This technique was carried out through the surgical incision trans diaphragmatically during anesthesia, which had no pain. In previous studies the patients were blocked transcutaneously in wake state after surgery.