Page 8 - Journal of WALS

Aman Nagpal et al

no clinical biochemical or ultrasonographic evidence of each other. Incidence of abdominal pain is slightly lower in
common bile duct (CBD) stones. Exclusion criteria for the drain group A than in group B except at 6 hours when
study group were acute pancreatitis, previous abdominal the incidence is equal in both groups. In both group
surgery, carcinoma gallbladder, history of peritonitis, patients experienced maximum pain at 6 hours
bleeding disorders, cirrhosis and pregnancy. The drain in postoperatively (3.20 vs 3.85; Table 2). Shoulder tip pain
group A was removed when the discharge was insignificant. was lower in group A in first 24 hours postoperatively.
All the subjects were observed postoperatively till discharge However, at 48 hours, group A had higher shoulder tip pain
from hospital for postoperative mortality in the form of pain– than group B.
incidence and site of pain, discharge in the drain tube-
hemorrhagic fluid or bile, duration of postoperative hospital Postoperative Incidence of Drain Site Pain
stay, postoperative pain based on visual analog score (VAS Drain site pain in terms of VAS score was significantly
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score), analgesia requirement, postoperative nausea and higher in group A at all times. Others also showed
vomiting and antiemetic required. concurrence with the present study with drain group having
Data was analyzed using statistical software SPSS less incidence of abdominal pain (38%) as compared to no
version 11.1. Mean and standard deviation was calculated drain group. So the present study is in resonance with above
for continuous variables like postoperative pain incidence authors. Reason for higher drain site pain is due to irritant
and VAS score. Chi-square and t-test was used as test of effect of drain, as the drain can induce a foreign body
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clinical significance. sensation, whereas group B had no significant pain at this
site. Regarding intensity of pain, contrary to our findings
RESULTS AND DISCUSSION are shown by others where author showed higher abdominal
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Data of 40 patients was included and analyzed in the study. pain at 23 hours in no drain group (2.24 vs 2.46) and beyond
Average age of the patients in present study was 36.25 years 23 hours (1.70 vs 1.86; Table 3).
in drain group and 37.90 years in no drain group. Male:
female ratio in both the groups in our study was 1:3.5 and Mean Pain Score at Different Sites in Study Groups
1:4 and overall ratio of the study was 1:3 which is compa- Overall mean pain score was higher in group A than in
rative with literature having male:female ratio of 1:3. 5,6 group B (Graph 1).

Intraoperative Comparison of Two Groups Comparison of Postoperative Analgesic
Requirement and Patients Required Antiemetics
Intraoperative Time in the Study Groups
Comparison of postoperative analgesic requirement showed
Mean operative time in groups A and B was 93 and higher usage in group B than in group A but it was not
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86 minutes respectively. Others reported that average statistically significant. Postoperative incidence of nausea/
operative time in group A was 33 minutes whereas average vomiting in group B was significantly higher than in
operative time in group B was 30 minutes. The difference group A up to 24 hours. Antiemetic requirement was
in the operating time depends on the experience of the significantly higher in group B than in group A at all times
surgeon. Although the mean operative time is more but (Table 4). In our study although incidence of abdominal
difference in time taken between both groups is comparable and shoulder tip pain was less in drain group, but this
which is supported by previous studies. difference was not statistically significant. Moreover, drain
site pain was statistically more in drain group. So there was
Intraoperative Complications in the Study Groups
no clear cut benefit in reducing postoperative pain in
Gallbladder rupture was most common complication laparoscopic cholecystectomy.
encountered in both the groups (Table 1).
Table 1: Intraoperative complications in the study groups
Postoperative Comparison of Two Groups Intraoperative complications Group A(%) Group B(%)

Postoperative Incidence and VAS Score of Gallbladder rupture 7 (35) 5 (25)
Pain Abdomen in Patients of Two Groups Cystic artery hemorrhage 2 (10) 0 (0)
0 (0)
CBD injury
1 (5)
Gastric perforation 1 (5) 0 (0)
At 12th postoperative hour, 90% of patients of group A and
95% of patients of group B had pain when compared with Total 11 5
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