Comparative study of postoperative analgesic effect of intraperitoneal instillation of dexmedetomidine with bupivacaine and bupivacaine alone after laparoscopic surgery

Oza, Vrinda; Parmar, Vandana; Badheka, Jigisha; Nanavati, Dharam S; Taur, Pradip; Rajyaguru, Ajay

doi:10.4103/0972-9941.181370

Cited by 19 publications

(15 citation statements)

References 9 publications

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“…The analgesia may be concentrated on the alleviation of inflammatory and oxidation reactions, 31 activation of central α 2 -adrenergic receptors in the locus coeruleus, 32 sedation, and prevention of EA. Consistent with other studies, 9 , 33 , 34 our results also prove that DEX favours reduction in the need for rescue analgesia during anaesthesia.…”

Section: Discussionsupporting

confidence: 92%

Effects of dexmedetomidine versus midazolam for premedication in paediatric anaesthesia with sevoflurane: A meta-analysis

Feng

Wang

et al. 2017

J Int Med Res

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BackgroundDexmedetomidine (DEX), an α2-adrenergic receptor agonist, produces ideal sedation and early postoperative recovery for premedication in paediatric surgery, reducing preoperative anxiety and facilitating smooth induction of anaesthesia. We performed a meta-analysis to compare the effects of DEX and midazolam (MDZ) in paediatric anaesthesia with sevoflurane.MethodsPubMed, Ovid, Web of Science, and Public Health Management Corporation were searched through December 2016 for randomized controlled trials (RCTs) that compared DEX and MDZ in children undergoing sevoflurane anaesthesia. The risk ratio (RR) with 95% incidence interval (95%CI) was used for dichotomous variables.ResultsTwelve RCTs involving 422 patients in the DEX group and 448 patients in the MDZ group were included. Patients in the DEX group had a significantly lower incidence of unsatisfactory sedation (RR [95%CI] = 0.71 [0.57–0.89]), unsatisfactory parental separation (RR [95%CI] = 0.56 [0.35–0.87]), and rescue analgesia (RR [95%CI] = 0.52 [0.35–0.77]) than patients in the MDZ group. However, both groups had a similar incidence of unsatisfactory mask acceptance, emergence agitation, and postoperative nausea and vomiting.ConclusionCompared with MDZ, DEX is beneficial in paediatric anaesthesia with sevoflurane because of its lower incidence of unsatisfactory sedation, parental separation, and rescue analgesia.

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Section: Discussionsupporting

confidence: 92%

Effects of dexmedetomidine versus midazolam for premedication in paediatric anaesthesia with sevoflurane: A meta-analysis

Feng

Wang

et al. 2017

J Int Med Res

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“…Similar to the results of the present study, other researchers have also revealed that intraperitoneal administration of DEX with bupivacaine, in laparoscopic gynecologic surgeries, was associated with a reduction in VAS and postoperative analgesic requirements in the hours of surgery (29)(30)(31). In addition to these results, the present study showed maximum painlessness at 48th hour postoperatively in DEX plus bupivacaine group.…”

Section: Discussionsupporting

confidence: 91%

The Impact of Intraperitoneal Dexmedetomidine with Bupivacaine on Patients’ Postoperative Pain in Endometriosis Laparoscopic Surgery; A Randomized, Clinical Trial

et al. 2019

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Background: Endometriosis is routinely treated with laparoscopy, which despite significant advantages over laparotomy cannot diminish postoperative pain. Insufficient postoperative pain control decreases patient satisfaction. Objectives: This study was designed to evaluate the efficacy of intraperitoneal dexmedetomidine (DEX) combined with bupivacaine on postoperative pain in endometriosis laparoscopic surgery. Methods: Fifty-three patients with endometriosis, scheduled for laparoscopy in Rasoul-e-Akram Hospital, Tehran, from January 2016 to May 2017 who were randomly divided into three groups, including group 1 (G1, n = 21) received 50 mL intraperitoneal saline, group 2 (G2, n = 16) received 50 mL intraperitoneal instillation of bupivacaine 0.25%, and group 3 (G3, n = 16) received 50 mL bupivacaine 0.25% plus dexmedetomidine 1 µg/kg. Each patient with a history of allergy to local anesthetics or dexmedetomidine, cardiac disease, renal or hepatic failure, severe pulmonary disease; in addition, pregnant and comorbid obese patients were excluded from the study. Patients' postoperative pain was assessed in the recovery room after 2, 6, 12, 24, and 48 hours using visual analogue scale (VAS). Total analgesic consumption was also recorded. Results: The postoperative VAS scores were significantly lower in group 3 than other groups in the recovery room, and 2, 6, 12, 24 and 48 hours after the surgery (P < 0.001). However, there was no significant difference between 1 and 2 groups. Furthermore, total VAS in the first 24 hours in group 3 was significantly lower than the two other groups (P < 0.001). Conclusions: We conclude 1 µg/kg intraperitoneal DEX administration combined with bupivacaine may prolong postoperative analgesia and decrease rescue analgesia requirement compared with bupivacaine alone.

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“…Many trials have reported dexmedetomidine as an adjuvant to IPLA in laparoscopic surgeries to improve postoperative pain scores, prolong the time to the first request of analgesia, and decrease the postoperative analgesic consumption. [ 6 19 ]…”

Section: Discussionmentioning

confidence: 99%

Intraperitoneal dexmedetomidine as an adjuvant to bupivacaine for postoperative pain management in children undergoing laparoscopic appendectomy: A prospective randomized trial

Elnabtity

Ibrahim

2018

Saudi J Anaesth

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Background and Aims:Intraperitoneal local anesthetic is an effective analgesic approach in laparoscopic appendectomy in adults. The aim of the study was to compare the postoperative pain when intraperitoneal bupivacaine is administered alone versus the addition of dexmedetomidine to it in children undergoing a laparoscopic appendectomy.Methods:In this prospective randomized trial, 52 children were randomly allocated to Group B who received intraperitoneal bupivacaine 0.25% (2 mg/kg) or Group BD who received intraperitoneal bupivacaine 0.25% (2 mg/kg) plus dexmedetomidine (1 mcg/kg) for postoperative analgesia in children undergoing laparoscopic appendectomy. Postoperative pethidine consumption at day 1 was recorded and considered the primary outcome of the study. Patients were evaluated for pain scores at 0, 2, 4, 6, 12, and 24 h, time to first request of pethidine, sedation scores at 0, 2, 4, and 6 h, length of hospital stay, and parents’ satisfaction. Chi-square, Fisher's exact, Student's t-test, and Mann–Whitney U-tests were used for analysis.Results:Postoperative visual analog scale scores were lower in Group BD at 2, 4, and 6 h (mean = 3, 3, 3, respectively) compared with Group B (mean = 4, 5, 4, respectively) (P < 0.05). Patients in Group BD had more sedation scores at 0, 2, and 4 h (P < 0.05), longer time to first rescue analgesia (P = 0.03), lesser rescue analgesic consumption (P = 0.02), shorter length of hospital stay (P = 0.02), and higher parents’ satisfaction (P = 0.01).Conclusion:Adding dexmedetomidine to intraperitoneal bupivacaine provides adequate postoperative analgesia in children undergoing laparoscopic appendectomy.

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Comparative study of postoperative analgesic effect of intraperitoneal instillation of dexmedetomidine with bupivacaine and bupivacaine alone after laparoscopic surgery

Cited by 19 publications

References 9 publications

Effects of dexmedetomidine versus midazolam for premedication in paediatric anaesthesia with sevoflurane: A meta-analysis

Effects of dexmedetomidine versus midazolam for premedication in paediatric anaesthesia with sevoflurane: A meta-analysis

The Impact of Intraperitoneal Dexmedetomidine with Bupivacaine on Patients’ Postoperative Pain in Endometriosis Laparoscopic Surgery; A Randomized, Clinical Trial

Intraperitoneal dexmedetomidine as an adjuvant to bupivacaine for postoperative pain management in children undergoing laparoscopic appendectomy: A prospective randomized trial

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