1Professor and Head, Dept. of Cardiac Anesthesia, G.S Medical College, Mumbai
2Resident, Dept. of Cardiac Anesthesia, G.S Medical College, Mumbai
3III MBBS, Student, Loni Medical College, Maharashtra
*Corresponding Author: E-mail: drmanjusarkar@gmail.com
Online published on 9 June, 2016.
Acute pain in the perioperative setting is detrimental to post operative outcome and adequate analgesia leads to better outcome.
Sixty ASA I/II patients between 18–65 years undergoing laparoscopic cholecystectomy and appendicectomy were included and randomly divided into 2 groups. ASA III/IV patients, previous opioid and alpha 2 agonist treatment and patients requiring extensive surgical dissection were excluded. Group D received IV Dexmedetomidine 1μg/kg over 10 min followed by 0.2–0.7 μg/kg/hr and Group P received IV Paracetamol 15 mg/kg prior to extubation. Patients were monitored for hemodynamics and VAS score was assessed after extubation till 24 hours. Rescue analgesia (IV tramadol 1 mg/kg) was given and the time interval till the requirement of first dose of rescue analgesia was recorded.
In group D, 12 patients required rescue analgesia as compared to 4 Patients in group P (40% vs13.3%; P=0.02). VAS scores were similar in both groups with group P showing trend towards low score. Median time at which the first dose of rescue analgesia was administered in group P was longer (134.42 + 12.67 vs 82.76 + 9.38 min; P=0.001). Incidence of bradycardia and hypotension was higher in group D (20% vs 3.3%; P=0.04).
Paracetamol is a superior to Dexmedetomidine for analgesia in short surgical procedures and should form a part of multimodal analgesia.
Dexmedetomidine, Paracetamol, Laparoscopic surgery, Analgesia
