Intraperitoneal instillation of ropivacaine plus dexmedetomidine for pain relief after laparoscopic hysterectomy: A comparison with ropivacaine alone

• Main Authors: Sunil Chiruvella, Srinivasa Rao Nallam
• Format: Article
• Language: English
• Published: Wolters Kluwer Medknow Publications 2016-01-01
• Series: Journal of Dr. NTR University of Health Sciences
• Subjects: Dexmedetomidine; intraperitoneal instillation; postoperative pain; ropivacaine
• Online Access: http://www.jdrntruhs.org/article.asp?issn=2277-8632;year=2016;volume=5;issue=2;spage=93;epage=97;aulast=Chiruvella

Background and Aims: Intraperitoneal (IP) instillation of local anesthetics has been shown to minimize postoperative pain after laparoscopic surgeries. We compared the antinociceptive effects of IP dexmedetomidine combined with ropivacaine with that of IP ropivacaine alone in the patients undergoing laparoscopic hysterectomy. Materials and Methods: At the end of laparoscopic hysterectomy, in a double-blind, randomized manner, one of the following injections was given intraperitoneally. The patients were allocated into the following two groups: The patients in ropivacaine group (R group) (N = 30) were given 30 mL of 0.2% ropivacaine plus 2 mL of normal saline; the patients in ropivacaine plus dexmedetomidine group (RD group) (N = 30) were given 30 mL of 0.2% ropivacaine combined with 1 μg/kg dexmedetomidine (diluted in 2 mL normal saline) through trocars. All the patients were given diclofenac sodium when they had pain [visual analogue scale (VAS) 3]. Results: VAS score at different time intervals, overall VAS in 24 h was significantly lower (1.86 ± 0.46 vs 4.7 ± 0.94), time to first request of analgesia (min) was longest (126 ± 24 vs 59 ± 13) and total analgesic consumption (mg) was lowest (95 ± 15 vs 175 ± 75) in RD group than in R group. Conclusion: The antinociceptive effects of the intraperitoneal instillation of ropivacaine in combination with dexmedetomidine is superior to ropivacaine alone.