POSTOPERATIVE ANALGESIC EFFICACY OF INTRAPERITONEAL ROPIVACAINE VERSUS INTRAPERITONEAL ROPIVACAINE WITH DEXMEDETOMIDINE IN LAPAROSCOPIC CHOLECYSTECTOMIES.

Dr. Aatif Nabi Shah; Dr. Ovaise Malik

Volume : X, Issue : III, March - 2020

POSTOPERATIVE ANALGESIC EFFICACY OF INTRAPERITONEAL ROPIVACAINE VERSUS INTRAPERITONEAL ROPIVACAINE WITH DEXMEDETOMIDINE IN LAPAROSCOPIC CHOLECYSTECTOMIES.

Dr. Aatif Nabi Shah, Dr. Ovaise Malik

Abstract :

Intraperitoneal ropivacaine has postoperative analgesic effects in laparoscopic abdominal surgeries. Dexmedetomidine has been used as intraperitoneal instillation for postoperative analgesia. In this study our aim was to compare the postoperative analgesic efficacy of ropivacaine alone and ropivacaine with dexmeditomidine when used as an intraperitoneal instillation in laparoscopic cholecystectomies(LC). Methods: One hundred patients aged 20 to 60 years of ASA physical status I and II undergoing laparoscopic cholecystectomies were divided into 2 groups of 50 each. Group A patients received intraperitoneal instillation of 2 mg/kg ropivacaine along with 1 microgram /kg of dexmedetomidine in 50 ml and in Group B, patients received intraperitoneal instillation of 2 mg/kg ropivacaine in 50 ml normal saline( NS) before creation of a pneumoperitoneum. Postoperative pain abdomen, time to first rescue analgesia and total analgesic consumption was compared between the two groups. Results: VAS ( visual analogue scale for pain abdomen) was significantly lower in group A as compared to Group B(2.52 ± 0.73 in group A vs 3.53 ± 1.75 at 12 hours in group B, p<0.0001) . Time to first request of analgesia was found to be significantly lower in Group B ( 212.19min ± 14.42) when compared to group A (472.12 ± 23.65, P = 0.001). No of doses of rescue analgesia in 24 hours(1.42 ± 0.62 in group A vs 3.37 ± 0.56 in group B, p<0.0001) and total analgesic consumption(1285.0 gm ± 61.14 in group A vs 2340.0gm ± 86.12 in group B, p<0.0001) was significantly lower in group A when compared to group B. Conclusion: Intraperitoneal dexmeditomidine with ropivacaine is more efficacious than Intraperitoneal ropivacaine alone for postoperative pain management in laparoscopic abdominal surgeries.