Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Acharya, Ranjita; Karan, Daisy; Khetan, Megha

doi:10.22159/ajpcr.2016.v9s3.14396

Cited by 4 publications

(4 citation statements)

References 22 publications

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“…more effective than dexmedetomidine and intraperitoneal bupivacaine in controlling postoperative pain in our study.Two studies in India compared the effects of intraperitoneal dexmedetomidine and bupivacaine in patients with gynecological surgery and abdominal hysterectomy(Pati, 2017; Anand et al, 2014;Behaeen et al, 2014;Acharya et al, 2016). The results of these studies were almost consistent with our findings, where the effects of all three drugs, bupivacaine, ketamine, and dexmedetomidine were evident in postoperative pain control.…”

supporting

confidence: 88%

The effect of intraperitoneal ketamine, dexmedetomidine and bupivacaine on postoperative pain control in patients undergoing abdominal hysterectomy

Shokrpour¹,

Akbari²,

Pazouki³

et al. 2022

Medical Science

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Introduction: Today, hysterectomy is one of the commonest types of surgery and is the one of the most prevalent surgical procedures in the United States after cesarean section (C-section). One of the important complications of hysterectomy is postoperative pain. To relieve this pain, various methods are used, including the use of analgesics such as intraperitoneal ketamine, dexmedetomidine and bupivacaine. Therefore, the present study is aimed to conduct a comparative study on the effect of intraperitoneal ketamine, dexmedetomidine and bupivacaine on postoperative pain control in patients undergoing abdominal hysterectomy. Materials and Methods: The present study is a randomized, double-blind clinical trial which performed on 105 patients during March 2019 to June 2020, undergoing abdominal hysterectomy who were randomly divided into three groups including D (dexmedetomidine), K (ketamine) and B (bupivacaine). The study groups were compared in terms of hemodynamics, postoperative pain score and amount of drug used after 24 hours after surgery, as well as duration of postoperative analgesia. The obtained data were statistically analyzed using Spss 22 statistical software using ANOVA and T test. Results: The results of this study revealed the effect of intraperitoneal dexmedetomidine, bupivacaine and ketamine in controlling the pain following abdominal hysterectomy, among which intraperitoneal ketamine was more effective in controlling postoperative pain, increasing postoperative pain relief, and reducing postoperative opioid use when compared with dexmedetomidine and bupivacaine. Conclusion: All three drugs, intraperitonealdexmedetomidine, bupivacaine and ketamine, were detected to be essential in controlling postoperative pain in patients with complete abdominal hysterectomy. However, the effect of intraperitoneal ketamine was found to be greater than that of the other two drugs.

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supporting

confidence: 88%

The effect of intraperitoneal ketamine, dexmedetomidine and bupivacaine on postoperative pain control in patients undergoing abdominal hysterectomy

Shokrpour¹,

Akbari²,

Pazouki³

et al. 2022

Medical Science

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Section: Discussionmentioning

confidence: 99%

“…Acharya et al ( 34 ) and Chiruvella et al ( 35 ) concluded that adding dexmedetomidine to ropivacaine was effective in the management of postoperative pain and reduced analgesic consumption following laparoscopic hysterectomy. They also found that this combination was superior to using ropivacaine alone ( 34 , 35 ) . In comparison with lidocaine, Ghisi et al ( 36 ) found no difference in the analgesic effect of ropivacaine in pain control after laparoscopic abdominal surgeries, but the cost of lidocaine was lower than that of ropivacaine.…”

Section: Discussionmentioning

confidence: 99%

Systematic review and meta-analysis of ropivacaine use in laparoscopic hysterectomy

Marchand¹,

Azadi²,

Sainz³

et al. 2021

tjod

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To assess the efficacy of all forms of ropivacaine administration for the management of pain and opioid use, specifically in patients undergoing laparoscopic hysterectomy. We searched PubMed, Cochrane CENTRAL, Web of Science, and SCOPUS for relevant clinical trials matching our eligibility criteria. Outcomes of interest included: Pain intensity (measured either by visual analog scale score or by numerical rating scale score), QoR-40 score (Overall quality of recovery tool, designed to measure physical comfort, physical independence, pain, emotional status, and need for support), and the need for opioid rescue. We performed the analysis under the fixed-effects model for homogeneous data and random-effects model for heterogeneous data. Most heterogeneous data were solved by the leave-one-out method, in cases where this was not successful, we then proceeded to conduct at least one subgroup meta-analysis in an attempt to solve heterogeneity. We assessed the risk of bias using Cochrane’s risk of bias tool. A total of five clinical trials were included. Regarding the pain score, there was no significant difference between either group [standardized mean difference=-0.17, 95% confidence interval (CI): (-0.56, 0.23); p=0.41]. The analysis of the overall RoQ40 scores favored the ropivacaine group over the control group significantly [mean difference (MD)=17.68, 95% CI: (1.48, 33.87); p<0.001]. Regarding the use of opioids, the analysis revealed no significant difference between either group [MD=-2.57, 95% CI: (-6.62, 1.49); p=0.21]. Ropivacaine administration by any method does not seem to be effective in reducing pain or reducing the need for opioid use after laparoscopic hysterectomy procedures; however, the administration did show a significant improvement in the patient’s “overall quality of recovery,” as measured using the QoR-40 tool.

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“…The patients were allocated into the following two groups: The patients in ropivacaine group (R group) (N = 40) were given 38 ml of 0.2% ropivacaine plus 2 ml of normal saline (NS) and the patients in ropivacaine plus dexmedetomidine group (RD group) (N = 40) were given 38 ml of 0.2% ropivacaine combined with 0.5 µg/kg dexmedetomidine (diluted in 2 ml NS) through trocars. It was concluded that the antinociceptive effects of the IP instillation of ropivacaine in combination with dexmedetomidine are superior to ropivacaine alone in laparoscopic hysterectomy case [11] . Abd El-Hamid AM et al evaluated the effect of intraperitoneal levobupivacaine plain and levobupivacaine plus sufentanil for postoperative analgesia after Laparoscopic cholecystectomy.…”

Section: Discussionmentioning

confidence: 99%

Assessment of intraperitoneal instillation of levobupivacaine plus Dexmedetomidine versus ropivacaine plus Dexmedetomidine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A comparative study

Janapati¹,

Anusha²,

Nagrale³

2021

Int. J. Med. Anesthesiology

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Background: The present study was undertaken for assessing and comparing the efficacy of Intraperitoneal Instillation of Levobupivacaine plus Dexmedetomidine and Ropivacaine plus Dexmedetomidine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Materials & methods: 40 patients were randomly divided into two groups of 20 each using sealed envelopes. Group A: Patients were given levobupivacaine plus Dexmedetomidine, and Group B: patients were given ropivacaine plus dexmedetomidine. Proforma was made and complete demographic and clinical profile of all the patients was recorded. Postoperatively the patients were assessed for pain utilizing visual analogue scale (VAS). Mean time to first analgesic requirement was recorded. All the results were recorded in Microsoft excel sheet and were analysed by SPSS software. Results: In the present study, mean age of the subjects of Group A and group B was 42.8 years and 45.3 years respectively. There were 12 males and 8 females in group A and 11 males and 9 females in group B. Mean VAS score among the subjects of group A at baseline, 1 hour, 6 hours and 12 hours was 1.3, 2.3, 2.5 and 1.9 respectively. Mean VAS score among the subjects of group B at baseline, 1 hour, 6 hours and 12 hours was 1.4, 2.7, 3.1 and 1.8 respectively. While comparing the VAS at different time intervals, non-significant results were obtained. Mean time to first analgesic requirement among the patients of group A and group B was 315.8 minutes and 267.4 minutes respectively. Significant results were obtained while comparing the mean time to first analgesic requirement among the subjects of the two study groups. Conclusion: Analgesia provided by Levobupivacaine plus Dexmedetomidine is significantly better than Ropivacaine plus Dexmedetomidine in terms of first analgesic requirement.

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Postoperative Analgesia With Intraperitoneal Ropivacaine With and Without Dexmedetomidine After Total Laparoscopic Hysterectomy: A Randomized, Double-Blind, Controlled Trial

Cited by 4 publications

References 22 publications

The effect of intraperitoneal ketamine, dexmedetomidine and bupivacaine on postoperative pain control in patients undergoing abdominal hysterectomy

The effect of intraperitoneal ketamine, dexmedetomidine and bupivacaine on postoperative pain control in patients undergoing abdominal hysterectomy

Systematic review and meta-analysis of ropivacaine use in laparoscopic hysterectomy

Assessment of intraperitoneal instillation of levobupivacaine plus Dexmedetomidine versus ropivacaine plus Dexmedetomidine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy: A comparative study

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