A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy
Background: In recent years, the use of intraperitoneal instillation of local anesthetics with adjuvants has become popular for postoperative analgesia in laparoscopic cholecystectomy. This study aimed to compare the analgesic efficacy and safety of levobupivacaine alone or with clonidine as an adju...
| Main Authors: | , , , , , |
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| Format: | Article |
| Language: | English |
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Wolters Kluwer Medknow Publications
2022-01-01
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| Series: | Journal of Dr. NTR University of Health Sciences |
| Subjects: | |
| Online Access: | http://www.jdrntruhs.org/article.asp?issn=2277-8632;year=2022;volume=11;issue=2;spage=126;epage=133;aulast=Jain |
| _version_ | 1797998836738686976 |
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| author | Neena Jain Surendra K Sethi Bhupendra Soni Veena Patodi Kavita Jain Deepak Kumar Garg |
| author_facet | Neena Jain Surendra K Sethi Bhupendra Soni Veena Patodi Kavita Jain Deepak Kumar Garg |
| author_sort | Neena Jain |
| collection | DOAJ |
| description | Background: In recent years, the use of intraperitoneal instillation of local anesthetics with adjuvants has become popular for postoperative analgesia in laparoscopic cholecystectomy. This study aimed to compare the analgesic efficacy and safety of levobupivacaine alone or with clonidine as an adjuvant given through intraperitoneal instillation in laparoscopic cholecystectomy under general anesthesia.
Material and Methods: In this prospective randomized double-blind study, 100 patients, aged 18–60 years belonging to ASA physical status I or II, were randomly allocated into two groups. Group L (n = 50) received 0.25% levobupivacaine 28 ml + 2 ml normal saline, whereas Group LC (n = 50) received 0.25% levobupivacaine 28 ml + clonidine 0.75 μg/kg (diluted in 2 ml normal saline) as intraperitoneal instillation before removing trocar. The duration of analgesia, pain scores, total number of doses, and amount of rescue analgesic consumed in 24 h, sedation score, hemodynamics, and adverse effects was noted.
Results: Duration of analgesia was significantly prolonged in Group LC (744.10 ± 96.72 min) compared to Group L (525.20 ± 67.91 min) (P < 0.05). Pain scores (VAS) were significantly lower in Group LC (P < 0.05). The total number of doses and amount of rescue analgesic consumption in 24 hours were less in Group LC as compared to Group L (P < 0.05). Sedation, hemodynamics, and side effect profile were comparable in two groups (P > 0.05).
Conclusion: Clonidine (0.75 μg/kg) was found to be a safe and effective adjuvant to 0.25% levobupivacaine for intraperitoneal instillation in laparoscopic cholecystectomy in terms of prolonged postoperative analgesia, lower pain scores, reduced rescue analgesic consumption along with no significant sedation, hemodynamic changes, and adverse effects. |
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| id | doaj.art-32e88a2e619840519fe9dfed30e79184 |
| institution | Directory Open Access Journal |
| issn | 2277-8632 |
| language | English |
| last_indexed | 2024-04-11T10:55:04Z |
| publishDate | 2022-01-01 |
| publisher | Wolters Kluwer Medknow Publications |
| record_format | Article |
| series | Journal of Dr. NTR University of Health Sciences |
| spelling | doaj.art-32e88a2e619840519fe9dfed30e791842022-12-22T04:28:48ZengWolters Kluwer Medknow PublicationsJournal of Dr. NTR University of Health Sciences2277-86322022-01-0111212613310.4103/jdrntruhs.jdrntruhs_119_21A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomyNeena JainSurendra K SethiBhupendra SoniVeena PatodiKavita JainDeepak Kumar GargBackground: In recent years, the use of intraperitoneal instillation of local anesthetics with adjuvants has become popular for postoperative analgesia in laparoscopic cholecystectomy. This study aimed to compare the analgesic efficacy and safety of levobupivacaine alone or with clonidine as an adjuvant given through intraperitoneal instillation in laparoscopic cholecystectomy under general anesthesia. Material and Methods: In this prospective randomized double-blind study, 100 patients, aged 18–60 years belonging to ASA physical status I or II, were randomly allocated into two groups. Group L (n = 50) received 0.25% levobupivacaine 28 ml + 2 ml normal saline, whereas Group LC (n = 50) received 0.25% levobupivacaine 28 ml + clonidine 0.75 μg/kg (diluted in 2 ml normal saline) as intraperitoneal instillation before removing trocar. The duration of analgesia, pain scores, total number of doses, and amount of rescue analgesic consumed in 24 h, sedation score, hemodynamics, and adverse effects was noted. Results: Duration of analgesia was significantly prolonged in Group LC (744.10 ± 96.72 min) compared to Group L (525.20 ± 67.91 min) (P < 0.05). Pain scores (VAS) were significantly lower in Group LC (P < 0.05). The total number of doses and amount of rescue analgesic consumption in 24 hours were less in Group LC as compared to Group L (P < 0.05). Sedation, hemodynamics, and side effect profile were comparable in two groups (P > 0.05). Conclusion: Clonidine (0.75 μg/kg) was found to be a safe and effective adjuvant to 0.25% levobupivacaine for intraperitoneal instillation in laparoscopic cholecystectomy in terms of prolonged postoperative analgesia, lower pain scores, reduced rescue analgesic consumption along with no significant sedation, hemodynamic changes, and adverse effects.http://www.jdrntruhs.org/article.asp?issn=2277-8632;year=2022;volume=11;issue=2;spage=126;epage=133;aulast=Jainclonidineduration of analgesiaintraperitoneal instillationlaparoscopic cholecystectomylevobupivacinerescue analgesic |
| spellingShingle | Neena Jain Surendra K Sethi Bhupendra Soni Veena Patodi Kavita Jain Deepak Kumar Garg A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy Journal of Dr. NTR University of Health Sciences clonidine duration of analgesia intraperitoneal instillation laparoscopic cholecystectomy levobupivacine rescue analgesic |
| title | A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy |
| title_full | A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy |
| title_fullStr | A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy |
| title_full_unstemmed | A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy |
| title_short | A comparative study to evaluate the efficacy of intraperitoneal instillation of 0.25% levobupivacaine with or without clonidine (0.75 μg/kg) for postoperative analgesia in patients undergoing laparoscopic cholecystectomy |
| title_sort | comparative study to evaluate the efficacy of intraperitoneal instillation of 0 25 levobupivacaine with or without clonidine 0 75 μg kg for postoperative analgesia in patients undergoing laparoscopic cholecystectomy |
| topic | clonidine duration of analgesia intraperitoneal instillation laparoscopic cholecystectomy levobupivacine rescue analgesic |
| url | http://www.jdrntruhs.org/article.asp?issn=2277-8632;year=2022;volume=11;issue=2;spage=126;epage=133;aulast=Jain |
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