Intraperitoneal bupivacaine alone or with dexmedetomidine for post-operative analgesia following laparoscopic cholecystectomy: A prospective randomized comparative study

Abstract

Background & objetives: Laparoscopic procedures are usually followed by postoperative pain of variable intensity. The pain occurs due to streching of the visceral organs and peritoneum. We compared the antinociceptive effect of intraperitoneal instillation of bupivacaine with a combination of bupivacaine and dexmedetomidine in laparoscopic surgery. We assessed the quality of analgesia, time to the first request of rescue analgesia and total analgesics required in the first 24 h.
 Methodology: After institutional ethical committee approval a total of 162 patients were selected, out of which 81 patients were allocated into two groups using table of randomization. Group B received 0.25 % bupivacaine 50 ml with 5 ml normal saline and Group BD received 0.25 % bupivacaine 50 ml plus dexmedetomidine 1 µg/kg diluted in 5 ml of normal saline intraperitoneally.
 Results: We found a significant difference between mean VAS scores of the two groups in all time points (p < 0.05). There was significant difference between mean time to the first request for analgesia and the mean total dose for analgesic required (p < 0.05) in between both groups.
 Conclusion: We conclude that intraperitoneal instillation of dexmedetomidine 1 µg kg in combination with bupivacaine 0.25% in elective laparoscopic cholecystectomy significantly reduces the postoperative pain and analgesic requirement in postoperative period when compared to bupivacaine 0.25% alone.
 Abbreviations: VAS – Visual analog scale; NS - Normal saline; PACU - post‑anesthesia care unit; HR – Heart rate;
 Key words: Anesthetics, Local / administration & dosage; Bupivacaine / administration & dosage; Cholecystectomy, Laparoscopic / adverse effects; Dexmedetomidine, Intraperitoneal; Bupivacaine; Visual analogue scale; Pain Measurement; Pain, Postoperative / diagnosis; Pain, Postoperative / etiology; Pain, Postoperative / prevention & control
 Citation: Shankar S, Gupta BK, Singh MK, Pandey AR, Dwivedi V, Sachan S. Intraperitoneal bupivacaine alone or with dexmedetomidine for post-operative analgesia following laparoscopic cholecystectomy: A prospective randomized comparative study. Anaesth. pain intensive care 2022;26(3):347-351. DOI: 10.35975/apic.v26i3.1909
 Received: August 09, 2021; Reviewed: November 19, 2021; Accepted: December 09, 2021