A STUDY OF COMPARISON OF ANTINOCICEPTIVE EFFECT OF INTRAPERITONEAL INSTILLATION OF BUPIVACAINE WITH CLONIDINE TO BUPIVACAINE WITH DEXMEDETOMIDINE IN LAPAROSCOPIC CHOLECYSTECTOMY

*Dr. Khedkar Sunita M., Dr. Chalkure Aniket N. and Dr. Bhalerao Pradnya M.

ABSTRACT

Nowadays laparoscopic cholecystectomy is the method of choice over open cholecystectomy. But it frequently results in significant immediate postoperative pain. Aims: The primary aim of this study was to compare the analgesic effects of intraperitoneal bupivacaine with dexmedetomidine and clonidine in patients undergoing laparoscopic cholecystectomy. Material and Methods: A total of 80 patients were included in this prospective, randomized study divided into two equal sized (n = 40) study groups . Patients of Group BC who received intraperitoneal lnj. Bupivacaine 30 ml 0.25% + Clonidine 1 ug/kg and Group BD who received lnj. Bupivacaine 30 ml 0.25% + Dexmedetomidine 1ug/ kg. The analgesia was assessed by visual analogue scale score (VAS). Time to the first request of analgesia, the total doses of analgesic in the first 24 hrs and adverse effects were noted. Results: In this study, bupivacaine in combination with dexmedetomidine has significantly lower VAS scores at all the points of time and overall VAS score than group BC. The mean number of doses of rescue analgesia required more in group BC was 3.38±0.63 then Group BD was 2.25 ± 0.78 in 24 hours postoperatively. The mean time for first request of rescue analgesia was less 115.50±109.87min in group BC than mean time in group BD 227.75±158.33 min. Conclusions: This study concluded that intraperitoneal instillation of dexmedetomidine in combination with bupivacaine in elective laparoscopic cholecystectomy significantly reduces the postoperative pain, the analgesic requirement in postoperative period as compared to bupivacaine with clonidine.

Keywords: Bupivacaine Hydrochloride, Intraperitoneal, Laparoscopic, Dexmedetomidine Hydrochloride, Clonidine.