Publication:

Intraperitoneal analgesia for postoperative pain relief after laparoscopic gynecological surgeries

Background Though laparoscopic gynaecological surgeries are less invasive and produces less post-operative pain, post-laparoscopy pain is still a concern. Intraperitoneal (IP) instillation of local anaesthetics has been shown to minimize the postoperative pain after laparoscopic surgeries. This study was conducted to compare the efficacy of intraperitoneal instillation of dexmedetomidine with bupivacaine and bupivacaine alone in reducing postoperative pain.

Methods 60 patients, enrolled for gynaecological laparoscopic surgeries were divided randomly into two groups of 30 each. Group B: Bupivacaine (30 ml, 0.25%) with 2 ml normal saline was instilled prior to removal of trocars, and Group BD: Bupivacaine (30 ml, 0.25%) with dexmedetomidine (1 mcg/kg, diluted to 2 ml) was instilled prior to removal of trocars. In postoperative period, Visual Analogue Score (VAS) was recorded up to 24 hours. Postoperative analgesic requirements, and side effects were recorded.

Results The Visual Analogue Score (VAS) during the first postoperative 24 hours was significantly lower in group BD compared to group B. Time to first analgesia required was delayed and total analgesic consumption was lower in group BD compared to group B which was statistically significant.

Conclusions Intraperitoneal instillation of dexmedetomidine with bupivacaine is an effective and safe method for reducing pain after laparoscopic gynaecological surgeries.