Intraperitoneal Instillation of Ropivacaine 0.375% with Dexmedetomidine vs Ropivacaine 0.375% with Clonidine for Postoperative Analgesia in Laproscopic Cholecystectomy: A Comparative Study

Abstract

Introduction: Laproscopic Cholecystectomy is a standard technique for symptomatic cholelithiasis. It is most commonly performed day care surgery. On the day of surgery pt experiences vague abdominal and shoulder pain. As the discharge is delayed due to lack of adequate analgesia, provision of adequate analgesia is of utmost importance. Objective: To compare the efficacy of postoperative analgesia after intraperitoneal instillation of 0.375% Ropivacaine with Dexmedetomidine vs 0.375% Ropivacaine with Clonidine Materials and Methods: 40 patients posted for laproscopic cholecystectomy were randomly divided into two groups A and B. Group A received 20 ml of 0.375% Ropivacaine with 1mcg/ kg of Dexmedetomididne and Group B received 0.375% Ropivacaine with 1mcg/Kg Clonidine intraperitoneally through the 10mm supraumbilical port before closure. Pain was recorded on Visual Analog Scale at frequent intervals for 24 hrs postoperatively and categorised as either mild, moderate or severe. Inj. Diclofenac 75mg iv was administered as rescue analgesic in pts with moderate to severe pain. Results: PostoperativeVAS score showed a statistically significant difference between both groups with lower values in Group A compared to Group B. (P< 0.05 ). The amount of rescue analgesia used was also less with dexmedetomidine as adjuvant. Conclusion: Ropivacaine 0.375% with 1mcg/kg Dexmedetomidine provided better postoperative analgesia and significantly less requirement of rescue analgesia as compared to 0.375% Ropivacaine with 1mcg/kg clonidine.