Abstract

Objective: To evaluate the analgesic efficacy of intraperitoneal dexmedetomidine versus nalbuphine as an adjunct to ropivacaine in laparoscopy cholecystectomy.rnMethods: In this randomised double-blinded study, 60 American Society of Anesthesiologists physical status I-II, 20-55 years, scheduled for laparoscopic cholecystectomy under general anaesthesia and were randomly allocated into three groups according to intraperitoneal instillation of study drugs through trocars. Group A: given 50 ml solution of 0.25% ropivacaine with dexmedetomidine 1mcg/kg, Group B: given 50 ml solution of 0.25% ropivacaine with 5 mg nalbuphine and Group C: given 50 ml solution of 0.25% ropivacaine with 10 mg nalbuphine. The primary outcome was duration of analgesia. Secondary outcomes consisted of total cumulative postoperative tramadol consumption, pain rating, haemodynamic variables and adverse effects.rnResults: The duration of postoperative analgesia for group A was significantly longer than for group B and group C (7.36±1.69 vs 4.11±0.832 vs 4.53±0.834 h; P=0.000). Group A also required less total tramadol consumption (650 vs 1250 vs 950 mg; P=0.025), less total number of rescue analgesia (13 vs 25 vs 19; P=0.025), less total number of patients required rescue analgesia (55 vs 90 vs 75%; P= 0.043), less pain scores and higher mean sedation score (P<0.05).rnConclusion: Greater postoperative analgesia and analgesic sparing effects were observed in patients receiving intraperitoneal instillation of 1mcg/kg, dexmedetomidine as adjunct to ropivacaine following laparoscopy cholecystectomy.