Vandana P, Ananya N, Muralikrishna D, Ponduru S, Renganathan V, Gopinath R. Analgesic efficacy of intra-peritoneal instillation of dexamethasone and bupivacaine versus bupivacaine following laparoscopic cholecystectomy - A randomised, double-blind controlled study.
Indian J Anaesth 2023;
67:999-1003. [PMID:
38213679 PMCID:
PMC10779981 DOI:
10.4103/ija.ija_275_23]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2023] [Revised: 09/25/2023] [Accepted: 09/26/2023] [Indexed: 01/13/2024] Open
Abstract
Background and Aims
Laparoscopy is associated with acute pain. We compared the effectiveness of intra-peritoneal dexamethasone with bupivacaine versus bupivacaine in patients undergoing laparoscopic cholecystectomy for postoperative analgesia.
Methods
This randomised study was conducted after approval from the institutional ethics committee and 84 patients were randomly allocated into bupivacaine with dexamethasone group (BD) (received 40 mL of 0.25% bupivacaine with 16 mg dexamethasone), and bupivacaine group (BB) (received 40 mL of 0.25% bupivacaine intra-peritoneally). Data analysis was done using R version 4.2.1. The visual analogue scale (VAS) score, total rescue analgesic dose, and time required for the first analgesic between groups were compared using the Wilcoxon rank sum test or t-test appropriately.
Results
VAS score was significantly lower in the BD group compared to the BB group until 2 h post-operatively with a mean difference of - 1.0 (95% confidence interval [CI] -1.5, -0.53), P < 0.001. The total rescue analgesic dose consumed was lower in the BD group (60.71 mg [29.80]) compared to the BB group (73.20 mg [11.57]) with a mean difference of - 12.5 mg (95% CI - 22.3, -2.68), P = 0.013. In addition, the time taken for the requirement of the first rescue analgesic was significantly longer in the BD group (417.1 min [276.0]) compared to the BB group (219.4 min [226.1]) with a mean difference of 197.7 (95% CI 75, 320), P = 0.002.
Conclusion
Intra-peritoneal instillation of 16 mg dexamethasone with 0.25% bupivacaine in laparoscopic cholecystectomy significantly reduces post-operative pain and requirement of rescue analgesic compared to 0.25% bupivacaine alone.
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