Intraperitoneal bupivacaine for effective pain relief after laparoscopic cholecystectomy.

Laparoscopic cholecystectomy is now widely practised. There are various methods of pain relief used but none has been assessed or compared following this procedure. We have assessed the analgesic effect of intraperitoneal bupivacaine in laparoscopic cholecystectomy. Sixty consecutive patients were randomly assigned to one of two groups. Patients in group 1 were given 20 ml of saline injected under vision into the region of the gallbladder bed. Patients in group 2 were given 20 ml of 0.25% bupivacaine in a similar fashion. Postoperative pain was assessed with a visual analogue pain scale and the site of pain was recorded. Patients in the bupivacaine group had less pain in the early postoperative period and a lower incidence of pain in the right hypochondrium. Intraperitoneal bupivacaine is a simple and effective treatment for postoperative pain after laparoscopic cholecystectomy.

Serum leptin levels in pregnant Pakistani females: relationship with body mass index and placental weight.

OBJECTIVE: To determine the serum leptin levels in Pakistani pregnant subjects at the time of delivery and to ascertain the relationship between serum leptin levels and related variables (weight, body mass index, placental weight, gestational age, parity) at delivery. SETTING: Lady Dufferin Hospital, and Ziauddin Hospital Karachi. METHODS: Leptin concentration was measured in 110 subjects from venous samples, using Active Human ELISA Kit (DSL-10-23100). Samples were selected according to the availability. RESULTS: Mean maternal weight, body mass index and placental weight were 64.3 +/- 13.8 kg, 27.1 +/- 5.8 kg/m2 and 523.5 +/- 90 gm, respectively. Gestational age was 36-41 weeks and maternal age was 18-35 years. Mean serum leptin level was 27.9 +/- 18.1 ng/ml. Serum leptin levels were found to be positively correlated with body weight (r = 0.73, p < 0.01), body mass index (r = 0.80, p < 0.01) and placental weight (r = 0.34, p < 0.05). Increased leptin levels were found in multigravida mothers (mean 30.2 +/- 17.5) than in primigravida mothers (23.1 +/- 18.9). CONCLUSION: Our results suggest that leptin does play role in body weight and energy regulation during pregnancy. The significant positive correlation between leptin and placental weight suggests that placenta may be the site of synthesis and/or secretion of leptin during pregnancy.