Comparison of Post-Operative Duration of Analgesia Following Intraperitoneal Bupivacaine-Tramadol and Bupivacaine-Magnesium Sulphate in Laparoscopic Cholecystectomy

Background: Effective postoperative pain management is essential for optimizing recovery and patient satisfaction following laparoscopic cholecystectomy.Combining bupivacaine with adjuncts like tramadol or magnesium sulphate may enhance analgesic effects, but their comparative efficacy for intraperitoneal administration remains unclear.Objective: To compare the post-operative duration of analgesia following intraperitoneal bupivacaine-tramadol and bupivacaine-magnesium sulphate in laparoscopic cholecystectomy.Study Design and Setting: A randomized controlled trial conducted at Department of Anaesthesia, Rashid Latif Medical College Lahore from January 2024 to June 2024.Methodology: A total of 150 patients undergoing elective laparoscopic cholecystectomy were randomly assigned to Group A (bupivacaine-tramadol) or Group B (bupivacaine-magnesium sulphate).Pain intensity was assessed using the Visual Analog Scale (VAS) at 1, 4, 8, 12, and 24 hours postoperatively.The duration of analgesia and rescue analgesic consumption were recorded.Adverse events were monitored to evaluate safety.Results: Group A demonstrated significantly lower VAS scores at 8, 12, and 24 hours (p < 0.05) and a longer duration of analgesia (10.5 2.1 hours vs. 8.3 2.5 hours, p = 0.01).Total rescue analgesic consumption was significantly lower in Group A (125 15 mg) compared to Group B (165 20 mg, p = 0.001).Adverse events were fewer in Group A, though the difference was not statistically significant.Conclusion: Intraperitoneal bupivacaine-tramadol provides superior postoperative pain relief compared to bupivacainemagnesium sulphate, with longer analgesia duration, reduced analgesic consumption, and a favorable safety profile.