1 3
World J Urol
DOI 10.1007/s00345-016-1942-z
ORIGINAL ARTICLE
Can intraperitoneal bupivacaine decreases pain in patients
undergoing laparoscopic live donor nephrectomy? A randomized
control trial
Ankush Jairath
1
· Arvind Ganpule
2
· Shinu Gupta
3
· Shashikant Mishra
2
·
Ravindra Sabnis
2
· Mahesh Desai
2
Received: 6 July 2016 / Accepted: 20 September 2016
© Springer-Verlag Berlin Heidelberg 2016
pain scores was statistically significant (p < 0.05) at 0, 2
and 4 h. The mean dose of rescue analgesia (pentazocin,
30 mg in one vial) in group A was 33 ± 26 mg which was
significantly less as compared to group B where it was
62 ± 28 mg. There was statistically insignificant difference
between all cardiorespiratory factories at all-time inter-
vals except for heart rate and mean blood pressure at 0 h in
group A as compared to group B.
Conclusions Intraperitoneal bupivacaine is a simple, safe,
inexpensive method for control of postoperative pain in
patients undergoing laparoscopic live donor nephrectomy.
Use of the correct dose and concentration of the drug are
essential for effective pain control.
Keywords Laparoscopic live donor nephrectomy ·
Intraperitoneal · Bupivacaine · Local anesthetic
Introduction
Renal transplantation is the treatment of choice for the
patients with end-stage renal disease [1]. Subjecting the
donor to an open procedure not only increases donor’s mor-
bidity in terms of increased hospital stay and large painful
scar, but also discouraged potential donors. This has moti-
vated the surgeons to come up with a less morbid technical
alternative, the laparoscopic donor nephrectomy and better
pain control measures. Laparoscopic live donor nephrec-
tomy (LLDN) is now the gold standard and preferred
method for kidney harvestation in renal transplant surgery.
Postoperative pain is the main cause of delay in resump-
tion of normal daily activity after any operative procedure.
Despite better understanding of pain pathophysiology,
pharmacology of analgesics and development of newer
more effective analgesic techniques, many patients still
Abstract
Purpose To evaluate effect of intraperitoneal bupivacaine
on postoperative pain in patients undergoing laparoscopic
live donor nephrectomy.
Methods Hundred patients undergoing laparoscopic live
donor nephrectomy were included in the study and were
divided randomly into two groups based on computer-
generated randomization chart of fifty each. Patients were
made familiar with VAS chart preoperatively. Group A
received 20 mL of 0.5 % bupivacaine, while group B
patients received 20 mL of 0.9 % normal saline intraperi-
toneally Postoperatively, patients were assessed based on
VAS and requirement of rescue analgesic, hemodynamic
parameters and presence of any adverse effects. Student’s t
test was used for statistical analysis.
Results At all-time interval, mean pain scores were higher
in group B than group A. The difference between the mean
* Ankush Jairath
ankushjairath@gmail.com
Arvind Ganpule
doctorarvind1@gmail.com
Shinu Gupta
shinujairath@rediffmail.com
Shashikant Mishra
mishra@mpuh.org
Ravindra Sabnis
rbsabnis@gmail.com
Mahesh Desai
mrdesai@mpuh.org
1
Muljibhai Patel Urological Hospital (MPUH), Dr Varendra
Desai Road, Nadiad, Gujrat, India
2
Muljibhai Patel Urological Hospital (MPUH), Nadiad, India
3
Civil Hospital, Ludhiana, India