Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy
Background: Laparoscopic cholecystectomy (LC) is a customary treatment for patients with symptomatic cholelithiasis. This study aimed to compare the mean duration of analgesia (DOA) of intraperitoneal bupivacaine (BPV) with dexmedetomidine (DEX) to intraperitoneal BPV alone in patients undergoing L...
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ziauddin University
2025-01-01
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| Series: | Pakistan Journal of Medicine and Dentistry |
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| Online Access: | https://ojs.zu.edu.pk/pjmd/article/view/3253 |
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| author | Anees Ahmad Ambreen Khan Syed Shakeel Ahmed Saima Noreen Mohammad Idrees Shahryar |
| author_facet | Anees Ahmad Ambreen Khan Syed Shakeel Ahmed Saima Noreen Mohammad Idrees Shahryar |
| author_sort | Anees Ahmad |
| collection | DOAJ |
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Background: Laparoscopic cholecystectomy (LC) is a customary treatment for patients with symptomatic cholelithiasis. This study aimed to compare the mean duration of analgesia (DOA) of intraperitoneal bupivacaine (BPV) with dexmedetomidine (DEX) to intraperitoneal BPV alone in patients undergoing LC.
Methods: This randomized controlled trial was done at the Department of Anesthesiology, Bahawalpur Victoria Hospital, Bahawalpur, Pakistan, from October 2023 to March 2024. A simple random sampling technique was adopted. A total of 68 cases undergoing LC were enrolled and randomly allocated to either Group-B (n=34) who received intraperitoneal BPV 50 ml 0.25%+5 ml normal saline and Group-BD (n=34) who were served intraperitoneal BPV 50 ml 0.25%+ DEX 1 μg/kg with normal saline 5 ml. The postoperative pain intensity for both groups was recorded and compared using a 10-point visual analogue score (VAS) at 0, 30 minutes, 1 hour, 2, 4, 6, 8, 12, and 24 hours. Independent sample t-test and chi-square test were used to compare data between groups taking p<0.05 as significant.
Results: The mean DOA in the patients in group B was 4.42±3.95 hours, and in group BD, it was 7.63±2.65 hours (p=0.0002). It was noted that pain scores were significantly low in Group BD at 1 hour (2.63±0.53 vs. 2.26±0.64, p=0.0116), 2 hours (2.81±0.56 vs. 2.43±0.73, p=0.0188), 4-hours (3.70±0.73 vs. 3.32±0.52, p=0.0160), and 6-hours (3.93±0.48 vs. 3.50±0.46, p=0.0003). BD group offered a significantly longer DOA (p=0.0002), an extended spell for rescue analgesia (p=0.0001), and a lesser dose of diclofenac (p=0.0137).
Conclusion: Intraperitoneal instillation of DEX 1 μg/kg with local anesthetic 0.25% BPV 50 ml at the end of surgery in patients undergoing LC significantly reduced the postoperative pain, especially up to six hours postoperatively.
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| format | Article |
| id | doaj-art-11d29e7b3f4648ed99cfff6fdaf2fe56 |
| institution | Kabale University |
| issn | 2313-7371 2308-2593 |
| language | English |
| publishDate | 2025-01-01 |
| publisher | ziauddin University |
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| series | Pakistan Journal of Medicine and Dentistry |
| spelling | doaj-art-11d29e7b3f4648ed99cfff6fdaf2fe562025-01-19T20:18:31Zengziauddin UniversityPakistan Journal of Medicine and Dentistry2313-73712308-25932025-01-0114110.36283/ziun-pjmd14-1/007Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic CholecystectomyAnees Ahmad0Ambreen Khan1Syed Shakeel Ahmed2Saima Noreen3Mohammad Idrees4Shahryar5Bahawal Victoria Hospital, Bahawalpur, Pakistan.Quaid-e-Azam Medical College, Bahawalpur, Pakistan.Shahida Islam Teaching Hospital, Lodhran, Pakistan.Bahawal Victoria Hospital, Bahawalpur, Pakistan.Bahawal Victoria Hospital, Bahawalpur, Pakistan.Rashid Latif Medical College, Lahore, Pakistan. Background: Laparoscopic cholecystectomy (LC) is a customary treatment for patients with symptomatic cholelithiasis. This study aimed to compare the mean duration of analgesia (DOA) of intraperitoneal bupivacaine (BPV) with dexmedetomidine (DEX) to intraperitoneal BPV alone in patients undergoing LC. Methods: This randomized controlled trial was done at the Department of Anesthesiology, Bahawalpur Victoria Hospital, Bahawalpur, Pakistan, from October 2023 to March 2024. A simple random sampling technique was adopted. A total of 68 cases undergoing LC were enrolled and randomly allocated to either Group-B (n=34) who received intraperitoneal BPV 50 ml 0.25%+5 ml normal saline and Group-BD (n=34) who were served intraperitoneal BPV 50 ml 0.25%+ DEX 1 μg/kg with normal saline 5 ml. The postoperative pain intensity for both groups was recorded and compared using a 10-point visual analogue score (VAS) at 0, 30 minutes, 1 hour, 2, 4, 6, 8, 12, and 24 hours. Independent sample t-test and chi-square test were used to compare data between groups taking p<0.05 as significant. Results: The mean DOA in the patients in group B was 4.42±3.95 hours, and in group BD, it was 7.63±2.65 hours (p=0.0002). It was noted that pain scores were significantly low in Group BD at 1 hour (2.63±0.53 vs. 2.26±0.64, p=0.0116), 2 hours (2.81±0.56 vs. 2.43±0.73, p=0.0188), 4-hours (3.70±0.73 vs. 3.32±0.52, p=0.0160), and 6-hours (3.93±0.48 vs. 3.50±0.46, p=0.0003). BD group offered a significantly longer DOA (p=0.0002), an extended spell for rescue analgesia (p=0.0001), and a lesser dose of diclofenac (p=0.0137). Conclusion: Intraperitoneal instillation of DEX 1 μg/kg with local anesthetic 0.25% BPV 50 ml at the end of surgery in patients undergoing LC significantly reduced the postoperative pain, especially up to six hours postoperatively. https://ojs.zu.edu.pk/pjmd/article/view/3253BupivacaineCholecystectomyDexmedetomidineIntraperitoneal InstillationLaparoscopy |
| spellingShingle | Anees Ahmad Ambreen Khan Syed Shakeel Ahmed Saima Noreen Mohammad Idrees Shahryar Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy Pakistan Journal of Medicine and Dentistry Bupivacaine Cholecystectomy Dexmedetomidine Intraperitoneal Instillation Laparoscopy |
| title | Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy |
| title_full | Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy |
| title_fullStr | Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy |
| title_full_unstemmed | Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy |
| title_short | Post-operative Analgesia with Intraperitoneal Bupivacaine Alone and with Dexmedetomidine Following Laparoscopic Cholecystectomy |
| title_sort | post operative analgesia with intraperitoneal bupivacaine alone and with dexmedetomidine following laparoscopic cholecystectomy |
| topic | Bupivacaine Cholecystectomy Dexmedetomidine Intraperitoneal Instillation Laparoscopy |
| url | https://ojs.zu.edu.pk/pjmd/article/view/3253 |
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