Intraperitoneal Ketamine Versus Bupivacaine for Postoperative Pain Control After Laparoscopic Cholecystectomy

Summary

The intraperitoneal approach is used in anesthesia to manage the pain associated with abdominal procedures. Few studies have been conducted comparing intraperitonela ketamine with bupivacaine for pain control in laparoscopic cholecystectomy (LC) patients. To compare effect of intraperitoneal ketamine versus bupivacaine for postoperative pain control after LC. Department of Anesthesiology, Critical Care and Pain Management, Liaquat National Hospital and Medical College, Karachi. Group K received ketamine whereas Group B received bupivacaine. In Group K, ketamine 0.25mg/kg diluted in normal saline to a total volume of 40 ml was instilled by the surgeon. In Group B, bupivacaine 2mg/kgdiluted in normal saline to a total volume of 40ml was administered. Tramadol 1.5 mg/kg to a maximum of 100 mg IV was given as rescue analgesia. The pain was assessed using a numeric rating scale (NRS) with zero being no pain to ten being the worst possible pain. Pain was assessed using NRS at 0 hour (immediate postoperative period), 2 hour, 4 hour, 6 hour and 12 hours postoperatively.

Timeline

Start

2022-01-01

Primary completion

2022-01-01

Completion

2022-07-01

Outcome

Met primary endpoint

paper At 5 min, the average pain score was 2.1 ± 0.5 in Group K and 2.8 ± 0.7 in Group B (p < 0.001). PMID 41087934 ↗

paper intraperitoneal instillation of ketamine at a dose of 0.25 mg/kg was superior to bupivacaine alone PMID 41087934 ↗

Publications

• Background Ziaei P, Kargar S, Dehghan MH, Madadizadeh F, Jamshidi HR. Clinical Trial of Intraperitoneal Administration of Ketamine Combined with Bupivacaine on Pain Status after Laparoscopic Cholecystectomy. Journal of Shahid Sadoughi University of Medical Sciences. 2022.
• Background Mostafa, R.H. and Mekki, Y.M.H., 2018. Comparative evaluation of intraperitoneal bupivacaine and bupivacaine ketamine combined with lung recruitment for reducing postoperative shoulder pain in laparoscopic cholecystectomy. Egyptian Journal of Anaesthesia, 34(4), pp.159-164.
• Background Moharari RS, Hadavi M, Pourfakhr P, Najafi A, Etezadi F, Khajavi MR. Evaluation of the postoperative analgesic efficacy of intraperitoneal ketamine compared with bupivacaine in laparoscopic cholecystectomy. Arch Anesthesiol Crit Care. 2016;2(1):146-9.
• Bughio S, Nadeem SM, Rahman A, Kasi PK, Hussain S, Tanwani H. Intraperitoneal ketamine versus bupivacaine for postoperative pain control after laparoscopic cholecystectomy - a double-blind randomized controlled trial. BMC Anesthesiol. 2025 Oct 14;25(1):500. doi: 10.1186/s12871-025-03386-3.

Drugs

Evaluation	Drug	Modality	Dose	Route
Comparator	Bupivacaine	Other / unclassified	2 mg/kg	Other
Subject	Ketamine	Small molecule	0.25 mg/kg	Other

Indications

No indication recorded.