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Mini cholecystectomy now a day stay surgery: anaesthetic management with multi modal analgesia
1Department of Anaesthesiology and Intensive Care, National Institute of Cardiovascular Diseases and Department of Surgery, Karachi.
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.
Conclusion:
Miinicholecystectomy as a day care procedure is safe, with good pain relief facilitating mobility and recovery with multimodal pain management strategy.