Intraperitoneal Analgesia for Laparoscopic Cholecystectomy: Use of Bupivacaine with and Without Dexmedetomidine as Adjuvant
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 2
Abstract
Abstract: Intraperitoneal instillation of local anaesthetic agents alone or in combination with opioids, ∝‑2 agonists such as dexmedetomidine have been found to reduce post operative pain following laparoscopic cholecystectomy. The purpose of this study was to assess the analgesic effect of the intraperitoneal administration of intraperitoneal dexmedetomidine combined with bupivacaine and intraperitoneal bupivacaine alone in patients undergoing laparoscopic cholecystectomy. One hundred patients of (ASA) physical status I-II of both sexes, aged between 18 to 60 years, equally divided in to two groups, randomly allocated to one of the groups using table of randomization, Group B (n = 50): Intraperitoneal bupivacaine 30 ml 0.25% +5 ml normal saline (NS), Group BD (n = 50): Intraperitoneal bupivacaine 30 ml 0.25% + dexmedetomidine1u g/kg (diluted in 5 ml NS). Visual analogue scale was recorded half and hours, 1, 2, 4, 6 and 24 hours postoperatively. Incidence of postoperative nausea and vomiting (PONV) was also recorded. In addition, supplementary analgesic and antiemetic consumption were assessed. Statistical analysis was performed using Microsoft (MS) Office Excel Software with the Student’s t‑test and Chi‑square test (level of significance P = 0.05). Pain intensity, as well as postoperative supplementary medications were significantly lower in Group BD,(2.12±0.91) as compared to Group B( 4.21±1.15). Time to first request of analgesia (min) was longest (132±20),(60±19) and total analgesic consumption (mg) was lowest (48 ± 18), (182 ± 80) in Group BD than Group B. Intraperitoneal instillation of dexmedetomidine in combination with bupivacaine is an effective method for management of postoperative pain after laparoscopic cholecystectomy. It significantly reduced supplementary postoperative analgesic and antiemetic medication.
Authors and Affiliations
Dr. Mohamad Ommid, Ummer Ali, Shahzada Gani, Shaheeda Akhter, Nuzhat ul Islam, Saba Ahad, Anka Amin, Humera Manzoor
Keywords
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