A randomized controlled comparative study of postoperative analgesic efficacy of low–dose bolus intravenous dexmedetomidine and intraperitoneal dexmedetomidine with bupivacaine in patients undergoing laparoscopic cholecystectomy

Dr Ratan Kumar Choudhary; Dr Atul Kaushik; Dr Shailza Sharma

Volume : IX, Issue : V, May - 2019

A randomized controlled comparative study of postoperative analgesic efficacy of low–dose bolus intravenous dexmedetomidine and intraperitoneal dexmedetomidine with bupivacaine in patients undergoing laparoscopic cholecystectomy

Dr Ratan Kumar Choudhary, Dr Atul Kaushik, Dr Shailza Sharma

Abstract :

Low–dose intravenous (IV) dexmedetomidine has been evaluated for obtunding the pneumoperitoneum–induced haemodynamic changes and its analgesic efficacy in laparoscopic cholecystectomy. The aim was to determine the postoperative analgesic efficacy of low–dose bolus of 0.5 μg/kg dexmedetomidine via intravenous (IV) and intraperitoneal (IP) route in laparoscopic cholecystectomy. Methods: Seventy–five patients, aged 18–60 years of ASA physical status I and II, undergoing laparoscopic cholecystectomy under general anaesthesia were included. Patients in Group A received IP bupivacaine. Patients in Group B received 0.5 μg/kg dexmedetomidine infusion IV after removal of gall bladder along with IP bupivacaine and Group C received 0.5 μg/kg dexmedetomidine in 40 mL of 0.25% bupivacaine IP. The primary outcome was ‘time to first request of analgesia‘ and the secondary outcomes were ‘total consumption of tramadol in 24 hours, visual analogue scale (VAS) pain score. Results: In total, 75 patients with 25 in each group were included. Time to first request of analgesia was found to be significantly lower in B (59.68 ± 71.05 min, P= 0.00) and C group (90.80 ± 80.46 min, P = 0.001) compared to Group C (59.68 ± 71.05 min). Mean tramadol consumption in 24 hours (152.40 ± 60.958 vs 137.64 ± 52.40 mg) and mean VAS pain score were comparable in both B and C groups in the initial 12 h. Conclusion: Low bolus dose of IP dexmedetomidine is as efficacious as IV dexmedetomidine (0.5 μg/kg) along with IP bupivacaine in laparoscopic cholecystectomy