A comparative study on intraperitoneal bupivacaine alone or with dexmedetomidine for post-operative analgesia following laparoscopic cholecystectomy

Background: Intraperitoneal instillations of local anaesthetic agents alone or in combination dexmedetomidine have been found to reduce post-operative pain following laparoscopic cholecystectomy. Aim: Comparing antinociceptive effects of intraperitoneal instillation of bupivacaine plain and bupivacaine with dexmedetomidine in patients undergoing laparoscopic cholecystectomy. Materials and methods: Study was conducted on 100 adult patients of ASA physical status 1 and 2 in the age group of 18 years to 60 years, posted for elective laparoscopic cholecystectomy under general anaesthesia. Patients were randomly divided on an alternate basis into two groups of 50 each. Group B: (n=50) patients received Intraperitoneal bupivacaine 50 ml 0.25% + 5 ml normal saline. Group DB: (n=50) Intraperitoneal bupivacaine 50 ml 0.25% + dexmedetomidine 1 μg/kg with normal saline 5 ml. Results: Mean pain scores were significantly lower in the group BD when compared to group B during the entire duration of the study. There was statistically significant difference in VAS pain score at 6, 8, 12, 18, 24 hours after surgery. Mean pain scores were significantly lower in the group BD when compared to group B during the entire duration of the study. There was statistically significant difference in VAS pain score at 6, 8, 12, 18, 24 hours after surgery. There was statistically significant difference between two groups of patients in terms of heart rate, systolic and diastolic blood pressure from 1 hour to 12 hours. 4 patients (8%) of group B and only 5 (10%) patients of groups B + D had postoperative nausea/vomiting, and 7 (14%) patients of group B and 2 (4%) patients of groups B+D had postoperative shoulder pain. Conclusion: Intraperitoneal instillation of dexmedetomidine with bupivacaine prolongs the duration of postoperative analgesia as compared to that with bupivacaine alone.