Observational study to compare the efficacy of Intraperitoneal Ropivacaine with dexmedetomidine versus fentanyl for postoperative analgesia in patients undergoing laparoscopic cholecystectomy

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.