A comparative evaluation of intraperitoneal instillation of 0.25% ropivacine alone or with dexmedetomidine for postoperative analgesia following laparoscopic cholecystectomy

https://doi.org/10.53730/ijhs.v6nS3.7550

Authors

  • Priyanka Soni MBBS, Junior Resident, Dept. of Anaesthesia, J.L.N. Medical College & Hospital, Ajmer, Rajasthan, India
  • Veena Mathur MD, Senior Professor, HOD, Dept. of Anaesthesia, J.L.N. Medical College & Hospital, Ajmer, Rajasthan, India
  • Mayank Sarawag MD, Professor, Department of Medicine, Jhalawar Medical College and attached Hospitals, Jhalawar, Rajasthan
  • Varun Kumar Saini MD, Associate Professor, Dept. of Anaesthesia, RUHS College of Medical Sciences, Jaipur, India

Keywords:

ropivacaine, dexmedetomidine, laparoscopic cholecystectomy

Abstract

Intraperitoneal instillation of local anesthetic agent with or without adjuvant in laparoscopic surgeries is a common practice now a days. This study aimed to assess the efficacy and safety of addition of dexmedetomidine (1µg/kg) to 0.25% ropivacaine by intraperitoneal instillation for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. This prospective, randomized, double blind study was conducted on 80 patients of  American society of Anaesthesiologists (ASA)  grade I and II, either sex, aged 18 to 60 years enrolled for laparoscopic cholecystectomy to receive either Ropivacaine (0.25%) 30ml + 5 ml  Normal saline (NS) in group R (n=40) or Ropivacaine (0.25%) 30ml + Dexmedetomidine (1µg/kg) + 5ml with NS  in group RD (n=40) by intraperitoneal instillation, before removing trocar. All  patients received infiltration of 20mL of (0.25%)  ropivacaine at trocar insertion site, being 6 ml in umbilical incision, 6 ml in epigastric incision and  4 ml in both working portals after gall bladder removal. Duration of analgesia using  Visual analog scale (VAS) score, total amount of rescue analgesic in 24 hrs, hemodynamic parameters, and any adverse effects were monitored. Student t test was used to analyze the metric parameters and chi square test was used to compare the categorical variables. 

Downloads

Download data is not yet available.

References

Bisgaard T, Kehlet H, Rosenberg J. Pain and convalescence after laparoscopic cholecystectomy. Eur J Surg. 2001;167:84–96

El-labban GM, Hokkam EN, El-labban MA, Morsy K, Saadl S, Heissam KS. Intraincisionalvsintraperitoneal infiltration of local anaesthetic for ontrolling early post-laparoscopic cholecystectomy pain.Journal of minimal access surgery. 2011;7(3):173.

Golubović S, Golubović V, Cindrić-Stančin M, SotošekTokmadžić V. Intraperitoneal analgesia for laparoscopic cholecystectomy: bupivacaine versus bupivacaine with tramadol. Collegium antropologicum. 2009 1;33(1):299-302.

Ahmed B, Elmawgoud AA, Dosa R. Antinociceptive effect of (ἀ 2 adrenoceptor agonist) dexmedetomidinevsmeperidine, topically, after laproscopicgynecologic surgery. J Med Sci2008;8:400 4

Liu SS, Hodgson PS. Local anaesthetics. In: Barash PG, Cullen BF, StoeltingRK, editors. Clinical Anaesthesia. 4th ed. Philadelphia, PA: Lippicott Williams & Wilkins; 2001. p. 449-69.

Kucuk C, Kadiogullari N, Canoler O, Savli S. A placebo-controlled comparison of bupivacaine and ropivacaine instillation for preventing postoperative pain after laparoscopic cholecystectomy. Surg Today. 2007; 37(5), 396-400.

Labaille T, MazoitJX, Paqueron X, Franco D, Benhamou D. The clinical efficacy and pharmacokinetics of intraperitonealropivacaine for laparoscopic cholecystectomy. Anesthesia& Analgesia. 2002 1;94(1):100-5.

Kamibayashi T, Maze M. Clinical uses of alpha2-Adrenergic agonists. Anesthesiology 2000;93(5):1345-9

Praveena BL, Bharathi B, Sahana VR. Intraperitonealropivacaine with dexmedetomidine or fentanyl for postoperative analgesia following laparoscopic cholecystectomy: A comparative randomized trial. Anesthesia, essays and researches. 2019 Jan;13(1):169

Chilkoti GT, Kumar M, Mohta M, Saxena AK, Sharma N, Singh J. Comparison of postoperative analgesic efficacy of low-dose bolus intravenous dexmedetomidine and intraperitonealdexmedetomidine with bupivacaine in patients undergoing laparoscopic cholecystectomy: A randomised, controlled trial. Indian journal of anaesthesia. 2019 Feb;63(2):106-113.

Gupta M, Naithani U, Singariya G, Gupta S . Comparison of 0.25% Ropivacaine for Intraperitoneal Instillation v/s Rectus Sheath Block for Postoperative Pain Relief Following Laparoscopic Cholecystectomy: A Prospective Study. Journal of Clinical and Diagnostic Research. 2016 ;10(8): UC10-UC15

DevalkarPriti S. &SalgaonkarSweta V. : Intraperitoneal Instillation of 0.25% Bupivacaine For Laparoscopic Cholecystectomy: Effect on Postoperative Pain. International Journal of current Medical and Applied sciences; 2016, 12(2),91-95 .

Boddy AP, Mehta S, Rhodes M. The effect of intraperitoneal local anaesthesia in laparoscopic cholecystectomy: a systematic review and meta-analysis. AnaesthAnalg. 2006;103:682-88.

Mohamed Maher Beder El Baz and Tamer El MetwallyFarahat.IntraperitonealLevobupivacaine Alone or with Dexmedetomidine for Postoperative Analgesia after Laparoscopic Cholecystectomy.Anesth Essays Res. 2018 Apr-Jun; 12(2): 355–358

Shukla U, Prabhakar T, Malhotra K, Srivastava D, Malhotra K. Intraperitoneal bupivacaine alone or with dexmedetomidine or tramadol for post-operative analgesia following laparoscopic cholecystectomy: A comparative evaluation. Indian journal of anaesthesia. 2015 ;59(4):234.

Acharya R, Karan D, Khetan M. Postoperative analgesia with intraperitonealropivacaine with and without dexmedetomidine after total laparoscopic hysterectomy: a randomized, double-blind, controlled trial. asian j pharm clin res,2016;vol 9,suppl.3,2016, 76-79.

Patel HS, SolankiN,Shah B, Namrata. Comparison of Intraperitoneal Instillation of Bupivacaine and Bupivacaine with Dexmedetomidine for Postoperative Analgesia after Laparoscopic Surgery .IJIRMS 2016; 1(7) :259-265

Bindra TK, Kumar P, Rani P, Kumar A, Bariar H. Preemptive Analgesia by Intraperitoneal Instillation of Ropivacaine in Laparoscopic Cholecystectomy. Anesth essays Res. 2017;11:740-4.

Wordliczek J,Banach M, Garlicki J, Wordliczek J, DobrogowskiJ .Influence of pre- or intraoperational use of Tramadol (preemptive or preventive analgesia)On tramadol requirement in the early Postoperative period. Pol J Pharmacol 2002;54;693-697

Chiruvella S, Nallam SR. Intraperitoneal instillation of ropivacaine plus dexmedetomidine for pain relief after laparoscopic hysterectomy: A comparison with ropivacaine alone. Journal of Dr. NTR University of Health Sciences. 2016 1;5(2):93

Kim TH, Kang H, Park JS, Chang IT, Park SG. Intraperitonealropivacaine instillation for postoperative pain relief after laparoscopic cholecystectomy. Journal of the Korean Surgical Society. 2010 1;79(2):130-6.

Published

18-05-2022

How to Cite

Soni, P., Mathur, V., Sarawag, M., & Saini, V. K. (2022). A comparative evaluation of intraperitoneal instillation of 0.25% ropivacine alone or with dexmedetomidine for postoperative analgesia following laparoscopic cholecystectomy. International Journal of Health Sciences, 6(S3), 6797–6808. https://doi.org/10.53730/ijhs.v6nS3.7550

Issue

Section

Peer Review Articles