Publication:

Efficacy of ultrasound guided erector spinae plane block with or without dexmedetomidine on the postoperative analgesia in patients undergoing laparoscopic cholecystectomy: a comparative study

Background A crucial problem in laparoscopic cholecystectomy, the most common intra-abdominal surgical procedure, is substantial postoperative pain despite improvements in anaesthesia and surgery. Many minor to medium level surgical procedures are associated with severe postoperative pain occurring in about 20-40% of the patients.

Methods The study groups were divided into two, named group A and group B. In Group A, all the patients were received, bilateral Erector Spinae Plane Block (ESPB) with 19 ml of 0.375% Ropivacaine + 1ml of 0.9% NS (20 ml on each side) and in the Group B, all the patients were received, bilateral Erector Spinae Plane Block (ESPB) with 19 ml of 0.375% Ropivacaine + 1ml of dexmedetomidine (0.5mcg/kg) (20 ml on each side).

Results Overall findings highlighted that Group B has superior pain control and hemodynamic stability as compared with Group B at multiple postoperative time intervals. Group A maintains higher heart rates and MAP values early on, suggesting different cardiovascular responses between the two treatment groups throughout the assessment period. None of the patients required atropine for treatment of bradycardia.

Conclusions The study showed that addition of dexmedetomidine to ropivacaine for ESP block in laparoscopic cholecystectomy resulted in superior postoperative analgesia and a reduction in the total consumption of rescue analgesics. Dexmedetomidine had a more favourable impact on hemodynamic parameters indicating better cardiovascular stability perioperatively.