Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
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Usg Guided Erector Epinae Plane Block Using Dexmeditomidine as an Adjuvant with Ropivacaine in Patients Coming for Elective Laparoscopic Cholecystectomy: A Prospective Randomised Double Blind Controlled Study
S.N. Dilip Kumar, Joshi Thomas and P.B. Omar Mukthar
Page: 4-10 | Received 22 Nov 2023, Published online: 08 Jan 2024
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Abstract
The USG guided erector spinae plane (ESP) block is a novel truncal intrafascial block administered at the level of T7 transverse process resulting spread of drug cranially and caudally from the site of injection.The aim of study is to compare the efficacy of USG guided ESP block using ropivacaine alone and ropivacaine with dexmeditomidine in prolonging postoperative analgesia and also in reducing rescue analgesics in first 24 hrs after laparoscopic cholecystectomy, along with comparing intraoperative hemodynamic changes. Sixty American Society of Anaesthesiology (ASA) grade I and II patients undergoing elective laparoscopic cholecystectomy surgery under general anesthesia were randomly assigned into two groups of 30 each. USG guided ESP block was given bilaterally using either 0.375% ropivacaine plus 50mcg of dexmeditomidine (16mL each side) in group RD or 0.375% ropivacaine alone (16mL each side) in group R before induction of anesthesia. Hemodynamic monitoring like SBP, DBP, HR, MAP, SpO2 were assessed before intubation, immediately after intubation, 5th min, 10th min, 15th min, 30th min, 60th min, 90th min and at the end of surgery. Pain was monitored postoperatively using visual analogue score for 24 hrs. The time at which first rescue analgesia was given were noted along with total analgesic consumption in 24 hrs. The demographic parameters like age, sex and BMI were not statistically significant. The total duration of analgesia was 5.42+0.54 hours in group R and 7.71+0.57 in group RD which was statistically significant (p = 0.000). The total duration of postoperative analgesia was 3.58+0.57 hours in group R and 5.71+0.8 in group RD which was statistically highly significant (p = 0.000). Total analgesic consumption in first 24 hrs after surgery was significantly high in group R when compared to group RD (p<0.05). Paracetamol 1gm was given intravenously whenever the VAS score was >4 followed by 100mg tramadol intravenously if VAS score had not come down after 30 min. We have also observed the adverse effects like nausea, vomiting, shivering, sedation and shoulder pain which were statistically not significant. USG guided ESP block improves postoperative analgesia in patients undergoing laparoscopic cholecystectomy with minimal hemodynamic changes and adverse effects.
How to cite this article:
S.N. Dilip Kumar, Joshi Thomas and P.B. Omar Mukthar. Usg Guided Erector Epinae Plane Block Using Dexmeditomidine as an Adjuvant with Ropivacaine
in Patients Coming for Elective Laparoscopic Cholecystectomy: A Prospective Randomised Double Blind Controlled Study.
DOI: https://doi.org/10.36478/10.59218/makrjms.2024.5.4.10
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2024.5.4.10