Comparison of intravenous fentanyl and propofol with and without local infiltration in patients undergoing bilateral abdominal tubectomies.

The aim of this study is to compare the total dose of propofol required, duration of post operative analgesia and time for rescue analgesia between two groups.

Randomized placebo controlled study conducted in BMCRI among 50 patients divided into 2 groups of 25 each. Both groups premedicated with inj. Midazolam 0.02mg/kg, inj.glycopyrolate 0.002 mg/kg and inj.fentanyl 2microgm/kg and induced with inj. Propofol 2mg/kg initially and 0.5mg/kg as top-up.Group A received inj.bupivacaine 0.5% 5cc subcutaneously and 5cc in the mesosalpinx while group B received normal saline.Anaesthesia maintained with oxygen: nitrous at 4:4 liters. Heart rate, blood pressure, oxygen saturation, total propofol dose, verbal rating scale for post-op pain and time for rescue analgesia were recorded at regular intervals.

The demographic characteristics were comparable. Systolic BP in group B (102.28±13.10) was less than in group A(114.88±12.08) P =0.001 at 15 min. Mean arterial pressure was reduced in group B(75.52±9.55) than group A (82.44±9.48) with p value 0.013. Total dose of propofol used in group A was less (136.60±10.18) compared with group B (169.20±18.35) with p<0.001. VRS >3 was statistically significant ( p=0.022)in group B( 6 patients) compared with group A (nil) at the end of 6 hrs. Time for rescue analgesia in group A was (3.92±1.07) as compared with group B(1.32±0.54) P<0.001.

Pre-incisional and mesosalpinx infiltration of 0.5% bupivacaine reduced the -propofol consumption with prolonged post-operative analgesia and better hemodynamics.