Comparative analgesic efficacy of ropivacaine versus bupivacaine as intraperitoneal instillation in laparoscopic cholecystectomy

Abstract

Background: Intraperitoneal instillation of local anesthetics, such as ropivacaine and bupivacaine, has shown promise for managing postoperative pain in laparoscopic cholecystectomy. This study compares the analgesic efficacy and safety profiles of these agents to determine optimal postoperative pain control.Materials and Methods: In this randomized study, 50 patients scheduled for laparoscopic cholecystectomy were divided into two groups: Group A received 20 ml of 0.5% ropivacaine, and Group B received 20 ml of 0.5% bupivacaine. Pain scores were measured using the Visual Analogue Scale (VAS) and Visual Rating Scale (VRS) at intervals of 2, 6, 8, 12, 16, and 24 hours. Rescue analgesia requirements and adverse events were also recorded.Results: Both groups experienced effective pain relief, though Group B (bupivacaine) had lower VAS and VRS scores at 8 and 16 hours, indicating extended analgesia. Group B also required delayed rescue analgesia. No severe adverse events were noted, and both drugs were well-tolerated.Conclusion: Bupivacaine may offer prolonged analgesic effects, though ropivacaine’s safer profile supports its use as a suitable alternative. Both agents are effective for pain control in laparoscopic cholecystectomy.