ABSTRACT
BACKGROUND: Intraperitoneal local anesthetic is an effective analgesic approach following laparoscopic cholecystectomy. AIMS: The aim of the present study was to compare the antinociceptive effects of intraperitoneal ropivacaine plus fentanyl with ropivacaine plus dexmedetomidine in patients undergoing laparoscopic cholecystectomy. SETTINGS AND DESIGNS: This was randomized, prospective, double-blinded, observational clinical study. METHODS: A total of 80 patients, undergoing elective laparoscopic cholecystectomy under general anesthesia were randomly assigned to one of the two equal groups to receive either of the following: Group RF (n = 40) were given 30 mL of 0.2% ropivacaine combined with 1 µg/kg fentanyl (diluted in 2 mL normal saline) and Group RD (n = 40) were given 30 mL of 0.2% ropivacaine combined with 1 µg/kg dexmedetomidine (diluted in 2 mL normal saline) through trocars. The quality of analgesia was assessed using visual analog scale score (VAS). Time to the first request of analgesia, the total dose of analgesic in the first 24 h and adverse effects were noted. STATISTICAL ANALYSIS: The data were analyzed with the Students' t-test and Chi-square test. RESULTS: VAS score at different time intervals, overall VAS in 24 h was significantly lower (1.68 ± 0.46 vs. 4.47 ± 0.94), time to first request of analgesia (min) was longest (122.7 ± 24.5 vs. 89.3 ± 13.2) and total analgesic consumption (mg) was lowest (95.3 ± 15.6 vs. 135.7 ± 75.1) in RD group than in RF group. CONCLUSION: The antinociceptive effect of the intraperitoneal instillation of ropivacaine in combination with dexmedetomidine is superior to ropivacaine combined with fentanyl.
ABSTRACT
BACKGROUND: The ideal dose of butorphanol for brachial plexus block is not well known. AIMS: This study was carried out to evaluate 1 mg and 2 mg of butorphanol added to 0.375% levobupivacaine, with regard to the duration of analgesia. Our study also sought to assess the onset and duration of sensorimotor blockade, hemodynamic effects, sedation, and adverse effects. SETTINGS AND DESIGN: This study was a prospective, randomized, double-blinded, and comparative study. METHODS: Eighty adult patients of either sex undergoing upper limb surgeries under supraclavicular brachial plexus block were randomly allocated into two groups. Group LB1 received 29 ml of 0.375% levobupivacaine plus 1 mg of butorphanol diluted in 1 ml of normal saline. Group LB2 received 29 ml of 0.375% levobupivacaine plus 2 mg of butorphanol diluted in 1 ml of normal saline. The onset and duration of sensorimotor blockade, level of sedation, duration of analgesia, and adverse effects were assessed. STATISTICAL ANALYSIS: The data were analyzed with Student's t-test and Chi-square test. RESULTS: The onset of sensory (P = 0.032) and motor block (P = 0.026) was earlier in Group LB2 than in Group LB1. The duration of analgesia was significantly prolonged in Group LB2 (643.55 ± 131.6 vs. 511.73 ± 128.6 min; P = 0.001). The incidence of sedation was observed in more number of patients in Group LB2 (P = 0.01). Furthermore, the incidence of nausea, vomiting, and pruritus were observed in more number of patients in Group LB2 (P < 0.05). CONCLUSION: Higher dose of butorphanol in brachial plexus block hastens the onset and prolongs the duration of sensorimotor blockade and analgesia but is associated with a higher incidence of sedation which requires intense monitoring.
