Comparative evaluation of intraperitoneal instillation of 0.25% ropivacine alone or with dexmedetomidine for postoperative analgesia following laparoscopic cholecystectomy

Abstract

Intraperitoneal instillation of local anesthetic agent with or without adjuvant in laparoscopic surgeries is a common practice now a days. This study aimed to assess the efficacy and safety of addition of dexmedetomidine (1µg/kg) to 0.25% ropivacaine by intraperitoneal instillation for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. This prospective, randomized, double blind study was conducted on 80 patients of American society of Anaesthesiologists (ASA) grade I and II, either sex, aged 18 to 60 years enrolled for laparoscopic cholecystectomy to receive either Ropivacaine (0.25%) 30ml + 5 ml Normal saline (NS) in group R (n=40) or Ropivacaine (0.25%) 30ml + Dexmedetomidine (1µg/kg) + 5ml with NS in group RD (n=40) by intraperitoneal instillation, before removing trocar. All patients received infiltration of 20mL of (0.25%) ropivacaine at trocar insertion site, being 6 ml in umbilical incision, 6 ml in epigastric incision and 4 ml in both working portals after gall bladder removal. Duration of analgesia using Visual analog scale (VAS) score, total amount of rescue analgesic in 24 hrs, hemodynamic parameters, and any adverse effects were monitored. Student t test was used to analyze the metric parameters and chi square test was used to compare the categorical variables.