Abstract Issue

Volume 12 Issue 1 (January- March) 2023

Original Articles

Comparative Study of Intra peritoneal Bupivacaine with Dexmedetomidine versus Intraperitoneal Bupivacaine with Fentanyl for post-operative analgesia in Laparoscopic Cholecystectomy in a tertiary care hospital in north India
Dr. Misger Mudasir Nazir, Dr. Nandita Mehta, Dr. K.S Mehta, Dr. Arshid Wani, Dr. Junaid Jeelani, Dr. Deeksha Kalia

Background: Postoperative analgesia in laparoscopic cholecystectomy significantly affects the recovery profile and discharge of the patient. This study compares fentanyl and dexmedetomidine as adjuvants to bupivacaine in intraperitoneal instillation after laparoscopic cholecystectomy, in terms of their impact on analgesic efficacy and recovery profile. Sixty patients were randomised into two groups with thirty patients in each group; group BF was administered 20 ml of 0.25% bupivacaine + 10 ml of 2 μg/kg fentanyl; and group BD received 20 ml of 0.25% bupivacaine + 10 ml of 1 μg/kg dexmedetomidine. After 8 h, Post-Anaesthesia Discharge Scoring System (PADS) scored for determining recovery profile. Analgesic profile was assessed using Verbal Rating Scale and rescue analgesia requirement seen. Sedation was scored using Ramsay sedation scoring. Results:Groups Bupivacaine + Fentanyl(BF)and Bupivacaine + Dexmedetomidine(BD) had a similar analgesic profile. Ramsay sedation scores were significantly higher in group BD when compared to group BF. However, the Post Anaesthesia Discharge Score (PADS) remained comparable in both groups (P = 1). Conclusion: Intraperitoneal instillation of bupivacaine in combination with dexmedetomidine or fentanyl significantly reduces postoperative pain scores, in patients undergoing laparoscopic cholecystectomy. However, fentanyl may be preferred over dexmedetomidine, because it causes less sedation and achieves a better score.

 
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