What is it about?
Comparison of Post-Operative Analgesia Laparoscopic Surgeries with Intraperitoneal Dexmedetomidine
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Why is it important?
Background: Though laparoscopy is associated with lesser postoperative pain, it is not completely a pain free procedure. Given the expanding role of ambulatory surgery and need to facilitate an earlier hospital discharge, improving postoperative pain control has become an important issue for anesthesiologists. Objective: To analyze the analgesic effect of intraperitoneal instillation of 1 μg/kg dexmedetomidine with 0.25% bupivacaine to that of 0.25% bupivacaine alone in patients undergoing laparoscopic surgeries. Methods: Sixty patients posted for elective laparoscopic surgeries were randomized into two groups - Group B: received 30 ml Bupivacaine 0.25%, Group BD: received 30 ml of mixture of Bupivacaine 0.25% with Dexmedetomidine (1 μg/kg), intraperitoneally before removing the trocar. The intensity of the pain was assessed using Visual Analog scale (VAS) at 30 min, 1 hour, 2 hours, 6 hours, 12 hours, and 24 hours. The duration of analgesia, demand for rescue analgesics and side effects, if any were noted. Results: The demographic variables were comparable. There was a significantly prolonged duration of post-operative analgesia, a significant reduction in VAS scores and analgesia requirement rate over the 24-hour period in Group BD. Though the heart rate decreased significantly in patients of dexmedetomidine group, they were hemodynamically stable. There was no significant difference in the incidence of adverse effects. Conclusion: The intraperitoneal instillation of Bupivacaine with 1 μg/kg of dexmedetomidine in laparoscopic surgeries is a better choice for postoperative analgesia with minimal side effects.
Perspectives
Background: Though laparoscopy is associated with lesser postoperative pain, it is not completely a pain free procedure. Given the expanding role of ambulatory surgery and need to facilitate an earlier hospital discharge, improving postoperative pain control has become an important issue for anesthesiologists. Objective: To analyze the analgesic effect of intraperitoneal instillation of 1 μg/kg dexmedetomidine with 0.25% bupivacaine to that of 0.25% bupivacaine alone in patients undergoing laparoscopic surgeries. Methods: Sixty patients posted for elective laparoscopic surgeries were randomized into two groups - Group B: received 30 ml Bupivacaine 0.25%, Group BD: received 30 ml of mixture of Bupivacaine 0.25% with Dexmedetomidine (1 μg/kg), intraperitoneally before removing the trocar. The intensity of the pain was assessed using Visual Analog scale (VAS) at 30 min, 1 hour, 2 hours, 6 hours, 12 hours, and 24 hours. The duration of analgesia, demand for rescue analgesics and side effects, if any were noted. Results: The demographic variables were comparable. There was a significantly prolonged duration of post-operative analgesia, a significant reduction in VAS scores and analgesia requirement rate over the 24-hour period in Group BD. Though the heart rate decreased significantly in patients of dexmedetomidine group, they were hemodynamically stable. There was no significant difference in the incidence of adverse effects. Conclusion: The intraperitoneal instillation of Bupivacaine with 1 μg/kg of dexmedetomidine in laparoscopic surgeries is a better choice for postoperative analgesia with minimal side effects.
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This page is a summary of: Comparison of Post-Operative Analgesia in Laparoscopic Surgeries with Intraperitoneal Dexmedetomidine with Bupivacaine and Bupivacaine Alone, Indian Journal of Anaesthesia and Analgesia, January 2019, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.6319.13.
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