Comparison of administration of intraperitoneal bupivacaine and intraperitoneal bupivacaine with dexmedetomidine in post laparoscopic cholecystectomy patients for post operative pain relief

Introduction: Intraperitoneal administration of local anesthetic found to be effective in controlling postoperative pain in laparoscopic surgeries. So, this prospective study was conducted to compare antinociceptive effect of intraperitoneal administration of bupivacaine and bupivacaine with dexmedetomidine in patients after undergoing Laparoscopic Cholecystectomy. Materials and Methods: A total of 60 patients of either sex undergoing laparoscopic cholecystectomy were randomly divided into two groups 30 patients in each. Group B received intraperitoneal 50ml bupivacaine 0.25 % (125mg). Group BD received intraperitoneal 50ml bupivacaine 0.25 % (125mg) and 50µg dexmedetomidine before removal of trocar at end of the surgery. Post op analgesia (VAS Score), sedation, Vitals was assessed at different time intervals. Time to first rescue analgesia, total dose of analgesic and adverse effect were noted. Results: We observed significant difference in mean VAS score at 8hr, 12hr, 16hr and 20hr between two group with 2.27+0.74, 3.03+0.67, 3.5+0.63, 4.03+0.72 in group B and 1.7+1.36, 2.1+1.09, 2.6+1.22, 3.03+1.09 in group BD respectively. The mean time to first rescue analgesia in group B was 8.86+ 4.13hrs and 11.64+ 3.95hrs in group BD. Total analgesic consumption was less in Group BD. Conclusion: Intraperitoneal instillation of bupivacaine with dexmedetomedine is superior to bupivacaine alone in terms of duration of post operative analgesia, total analgesic consumption in the post laparoscopic cholecystectomy patients.