Title: Comparative Study of Intraperitoneal Instillation and Periportal Infiltration Of 0.5% Or 0.75% Ropivacaine with Dexmedetomidine as Adjuvant for Post Operative Analgesia in Laparoscopic Cholecystectomy
Authors: Kanta Bhati, Vandana Bhatnagar, Mohd. Yunus Khilji, Naresh Kumar Sharma
DOI: https://dx.doi.org/10.18535/jmscr/v7i7.03
Abstract
Aim and Objectives: To compare the analgesic efficacy and safety of two different concentration of ropivacaine with dexmedetomidine as adjuvant by intraperitoneal instillation and port site infiltration, for post-operative analgesia in laparoscopic cholecystectomy under General Anaesthesia.
Material and Method: 90 patients of ASA grade I and II aged 18-65 years, randomly allocated in 3 group in this prospective randomized controlled double blind study. In group-I 0.9% Normal saline(40 ml), In group -II 0.5% Ropivacaine (20 ml )+ Dexmedetomidine (1mcg/kg) and in group-III, 0.75% Ropivacaine (20 ml) +Dexmedetomidine (1mcg/kg) were taken and diluted with saline up to 40 ml . 20 ml instilled intraperitoneally before removing trocar and 20 ml infiltered at port site after removal of trocar. All patients were assessed for VAS Score, duration of analgesia, total analgesic consumption in 12 and 24 hrs and any adverse effects or complication in postoperative period.
Results: Duration of analgesia (hrs) was longer with 0.75% ropivacaine (6.5±3.06), as compared to 0.5% ropivacaine (4.07 ± 2.42) and control group(0.725 ±0.31)
Total analgesic consumption in 12 and 24 hours was lesser with 0.75% ropivacaine (1±0.45, 1.43±0.72) as compare to 0.5% ropivacaine ( 1.13±0.57, 1.76±0.77) and control group ( 2.3± 0.46, 3.53±0.5)
Conclusion: Intra-peritoneal instillation and port site infiltration of 0.75% Ropivacaine with dexmedetomidine provides superior and prolonged pain relief without any adverse effects, making its use simple safe and effective for postoperative analgesia in laparoscopic cholecystectomy.
Keywords: Ropivacaine, dexmedetomidine , Laparoscopic cholecystectomy.
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