European Journal of Molecular & Clinical Medicine

Abstract

Background: Instillation of intraperitoneal lignocaine, bupivacaine, levobupivacaine
and ropivacaine has been used following laparoscopic gynaecological and
general surgical procedures to reduce postoperative pain through randomized trials for
many years. Hence; the present study was undertaken for assessing and comparing the
efficacy of Intraperitoneal Instillation of Levobupivacaine (0.25%) plus Dexmedetomidine
and Ropivacaine (0.25%) plus Dexmedetomidine for postoperative analgesia in patients
undergoing laparoscopic cholecystectomy.
Materials & methods: 90 patients were enrolled and were randomly divided into three
groups of 30 each using sealed envelopes. Group L: Patients who were given 20 ml of 0.5%
levobupivacaine plus dexmedetomidine @ dose of 1 μgm per kg body weight and the
remaining volume by adding normal saline to make total volume 40ml, intraperitoneally
after gall bladder removal. Group R: Patients who were given 20 ml of 0.5% ropivacaine
plus dexmedetomidine @ dose of 1 μgm per kg body weight and the remaining volume by
adding normal saline to make total volume 40ml, intraperitoneally after gall bladder
removal. Group C: Patient who were given 40 ml of normal saline. Postoperatively the
patients were assessed for pain utilizing visual analogue scale (VAS). The result were
analyzed and compared to previous studies.
Results: The mean VAS scores readings were recorded postoperatively in all the three
groups at 0, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours. 0 time was the time of end of surgery. The
mean VAS score reading was lower in Group L and Group R in comparison to group C at
all the time intervals. The number of patients requiring rescue analgesia was significantly
higher in the control group in comparison to other study groups. Among the L group and
R group, the number of patients requiring rescue analgesia was lower in group L in
comparison to group R.
Conclusion: Intraperitoneal instillation of local anaesthetic solution in laparoscopic
cholecystectomy provides effective postoperative analgesia, and analgesia provided by
Levobupivacaine plus Dexmedetomidine is significantly better than Ropivacaine plus
Dexmedetomidine.
Materials & methods: 90 patients were enrolled and were randomly divided into three groups of 30 each using sealed envelopes. Group L: Patients who were given 20 ml of 0.5% levobupivacaine plus dexmedetomidine @ dose of 1 μgm per kg body weight and the remaining volume by adding normal saline to make total volume 40ml, intraperitoneally after gall bladder removal. Group R: Patients who were given 20 ml of 0.5% ropivacaine plus dexmedetomidine @ dose of 1 μgm per kg body weight and the remaining volume by adding normal saline to make total volume 40ml, intraperitoneally after gall bladder removal. Group C: Patient who were given 40 ml of normal saline. Postoperatively the patients were assessed for pain utilizing visual analogue scale (VAS). The result were analyzed and compared to previous studies.
Results: The mean VAS scores readings were recorded postoperatively in all the three groups at 0, 0.5, 1, 2, 4, 6, 8, 12 and 24 hours. 0 time was the time of end of surgery. The mean VAS score reading was lower in Group L and Group R in comparison to group C at all the time intervals. The number of patients requiring rescue analgesia was significantly higher in the control group in comparison to other study groups. Among the L group and R group, the number of patients requiring rescue analgesia was lower in group L in comparison to group R. Conclusion: Intraperitoneal instillation of local anaesthetic solution in laparoscopic cholecystectomy provides effective postoperative analgesia, and analgesia provided byLevobupivacaine plus Dexmedetomidine is significantly better than Ropivacaine plus Dexmedetomidine.