A randomised, prospective, double blind study of intraperitoneal instillation of 0.25% bupivacaine with clonidine versus 0.25% bupivacaine with dexmedetomidine for post-operative analgesia in patients undergoing laparoscopic cholecystectomy

Abstract

Laparoscopic cholecystectomy is the standard and most accepted technique for Cholecystectomies due to lesser postop pain and short recovery time.The origin of abdominal and shoulder pain after laparoscopic procedures has led to the use of intra peritoneal instillation of local anaesthetic agent to reduce postoperative pain. To assess the efficacy and quality of postoperative analgesia between the study groups using Visual Analogue Scale (VAS) score at various time intervals along with side effects if any.: 60 patients belonging to ASA 1 and 11 categories posted for Laparoscopic Cholecystectomy were given General Anaesthesia. After completion of surgery, before removing the trocar, anaesthetic study solution was sprayed on the surface of liver, gall bladder bed, right sub-diaphragmatic space, and port sites in Trendelenburg position. Volume and dilution of two drugs were same in both groups. Bupivacaine (0.25%) 50 mL; Dexmedetomidine (1 µg/kg) (BD) or Clonidine (1 µg/kg) (BC) was used. VAS score, Heart rate and BP measured at various time intervals and the time of first rescue analgesia noted.: VAS of BD group was 5.27 ± 0.64 to 3.70 ± 0.837 from 1 hour to 6 hour post extubation, when compared to BC group of 6.03 ± 0.669 in 1 hour reduced to 4.17 ± 0.699 at 6 hour post extubation. Dexmedetomidine combination significantly reduced the total dose of rescue analgesic required in 24 hours as compared to Clonidine combination.