Lignocaine versus dexmedetomidine infusion for post-operative pain relief in patients undergoing laparoscopic cholecystectomy: A randomised controlled study
Anjali Gera, Pradeep Jain, Prabhat Kumar Choudhary, Keshav J. SankpalABSTRACT
Background and Aim:
Opioid-sparing multi-modal analgesia is an important component of the enhanced recovery after surgery (ERAS) protocol. Lignocaine and dexmedetomidine have emerged as effective anaesthetic adjuvants. Laparoscopic cholecystectomy, an ambulatory surgery, has advantages such as better patient satisfaction, a significant reduction in hospital stay and a rapid return to normal activities. The primary aim of this study was to compare post-operative pain relief using the Visual Analogue Scale (VAS) score at 2, 4, 8, 12 and 24 h. Secondary objectives included intra-operative haemodynamic stability, post-operative nausea and vomiting (PONV), recovery of bowel function, post-operative sedation and satisfaction scores.
Materials and Methods:
This study included 78 American Society of Anesthesiologists 1 or 2 patients aged 18–65 years who underwent laparoscopic cholecystectomy under general anaesthesia at our institute. The patients were allocated to three groups: lignocaine (1%), dexmedetomidine (3.3 μg/ml) and normal saline. The standard anaesthesia technique was followed. A bolus injection of the study drug (1.5 ml/kg) was administered at induction, followed by an infusion of 0.15 ml/kg/h.
Results:
The three study groups were comparable to each other. VAS scores were significantly higher in Group 3 until 12 h, and the requirement for rescue analgesia was significantly higher in Group 3 at 2 and 4 h postoperatively. Patient satisfaction scores were lower in Group 3 than in Groups 1 and 2.
Conclusion:
Intra-operative lignocaine and dexmedetomidine provided significant pain relief and maintained haemodynamics. Both drugs decreased PONV and increased patient satisfaction. Lignocaine is accompanied by an early return of bowel function, and dexmedetomidine is associated with post-operative sedation.