Mini cholecystectomy now a day stay surgery: anaesthetic management with multi modal analgesia.
OBJECTIVE
To develop anaesthetic techniques for mini cholecystectomy in a day care set up.


METHODS
Fifty patients in ASA grade I and II scheduled for minicholecystectomy were selected. They were given Inj. Ketoralac 30 mg intramuscular 45 minutes prior to surgery. Inj. pethidine 0.5 mg/kg intravenous was given at induction and Inj. bupivacaine 0.5% plain 10 ml was infiltered into the wound at the end of surgery.


RESULTS
The mean age was 43.4 +/- 6.1 years with a preponderance of females (41 of 51). Thirty eight belonged to ASA grade I and 12 were in ASA grade II. Mean duration of surgery was 28.8 +/- 5.1 minutes. Size of minicholecystectomy incision was 3.9 +/- 0.4 cms. Two patients required additional opioid peroperatively, while two patients were given opioids post operatively. They were discharged from the PACUI at aldrete score > or = 9 at 61.4 +/- 6.3 minutes while 47 patients were discharged from PACU II at PADSS score 7 > = or 9,172.1 +/- 11.4 minutes after surgery. The incidence of nausea was 6% with confidence interval of 95% range (5.0-23.3). Three patients were admitted. None of our patients required a readmission.


CONCLUSIONS
Miinicholecystectomy as a day care procedure is safe, with good pain relief facilitating mobility and recovery with multimodal pain management strategy.
Amjad
N
N
Department of Anaesthesiology and Intensive Care, National Institute of Cardiovascular Diseases and Department of Surgery, Karachi.
Fazal
A
A
D000328:Adult; D000556:Ambulatory Surgical Procedures / Q000592:standards* / Q000639:trends; D000758:Anesthesia / Q000379:methods*; D018686:Anesthetics, Intravenous / Q000627:therapeutic use*; D002045:Bupivacaine / Q000627:therapeutic use; D017081:Cholecystectomy, Laparoscopic / Q000009:adverse effects / Q000379:methods*; D002769:Cholelithiasis / Q000000981:diagnostic imaging / Q000601:surgery*; D016001:Confidence Intervals; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D019060:Minimally Invasive Surgical Procedures / Q000009:adverse effects / Q000379:methods; D010147:Pain Measurement; D010149:Postoperative Pain / Q000175:diagnosis*; D010154:Pakistan; D017060:Patient Satisfaction; D011336:Probability; D011446:Prospective Studies; D012494:Sampling Studies; D016896:Treatment Outcome; D014463:Ultrasonography
D018686:Anesthetics, Intravenous; D002045:Bupivacaine