Additive interaction of intraperitoneal dexmedetomidine and topical nimesulide, celecoxib, and DFU for antinociception

Efficacy and Safety of Intraperitoneal Dexmedetomidine with Bupivacaine in Laparoscopic Colorectal Cancer Surgery, a Randomized Trial

“…Nearly 80% of patients after laparoscopic surgery need opioid analgesia in the postoperative period . Visceral signaling occurs through the enteric nervous system which is complex and partly independent of the central nervous system with a vast network of distinct, and functionally diverse, neuronal subtypes .…”

“…Dex has been used to premedicate and sedate patients undergoing day‐case procedures without adverse effects . A recent study conducted on rats suggested that a combination of topical Cox‐2 inhibitors with intraperitoneal Dex yielded additive analgesic effect . Esmaoglu et al studied the addition of Dex to lidocaine for intravenous regional anesthesia and found improved analgesia, increased time to the first postoperative analgesic requirement, and reduced total analgesic requirement.…”

α2‐Agonists as analgesic agents

“…[110][111][112] Similar to clonidine, dexmedetomidine decreases requirements for opioids in patients undergoing a variety of surgical procedures [113][114][115] and in a clinical trial involving 754 patients, where it was administered as single agent for sedation, it reduced by approximately 60% the number of patients who needed opioids for the control of pain. 114 A recent study reported the interaction, evaluated by tail-flick test, between some topically administered, nonsteroidal anti-inflammatory drugs (NSAIDs) and intraperitoneal dexmedetomidine: 116 the results, clearly demonstrate the additive analgesic affect of NSAIDs and dexmedetomidine.…”