Abstract
Intraperitoneal instillation of local anaesthetics with adjuvant has been used to control postoperative pain after laproscopic cholecystectomy. Aim: Compare efficacy of intraperitoneal ropivacaine with dexmedetomidine/fentanyl for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Methods: After obtaining ethical committee approval and informed consent, 62 patients aged 18-60 years, ASA I&II were divided into two groups; Group D: 18ml ropivacaine0.75% with 1µg/kg dexmedetomidine (2ml),Group F: 18ml ropivacaine0.75% with 1µg/kg fentanyl (2ml), instilled intraperitoneally after dissection of gallbladder in gallbladder fossa. Hemodynamic parameters were noted 1minute after instillation and every 15 minutes till 1hour and every hourly till 6hrs. Post-operative analgesia assessed by VAS score 1/2 hourly till 1hr and then hourly till VAS≥4 was reached. Results: Hemodynamic parameters were significantly lower in Group D upto 6hrs after instillation (p<0.05) and VAS was lower in Group D till 8hrs(p<0.05) post instillation as compared to group F. The duration of postoperative analgesia in Group D was 6.9±1.42 hours which was significantly longer than Group F was 3.41±0.84 hours,(p=0.001). Conclusion: Intraperitoneal instillation of ropivacaine with dexmedetomidine is more effective for post operative analgesia than ropivacaine with fentanyl for patients undergoing laproscopic cholecystectomy.
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