Comparison of Analgesic effects between Interpleural Bupivacaine with Adrenaline and Interpleural Bupivacaine with Adrenaline & Clonidine in Laparoscopic Cholecystectomy

Abstract

Study Design: Prospective study. Materials and method: This study was conducted in the Department of Anaesthesiology, Govt Medical College, Jammu 2011-2012. In this study, 75 adult patients of age 18 -60 years of either sex belonging to ASA I&II, admitted in surgical ward for elective lapraoscopic cholcystectomy were taken for this study. Patients were randomly divided into three groups. • Group I - Patients who received normal saline 20ml at the end of surgery. • Group II - Patients who received bupivacaine with adrenaline at the end of surgery. • Group III- Patients who received bupivacaine with adrenaline and clonidine at the end of surgery. Anaesthesia was standardized, consisting of glycopyrrolate 0.2 mg and ranitidine 50mg as premedication i.v 30min before induction. Induction was done with thiopentone sodium 5mg/kg and atracurium 0.5mg/kg IV, followed by maintenance with isoflurane and nitrous oxide 60-70% with oxygen. Pain assessments were made using 'Visual Analogue Scale' first in recovery ward after surgery and then 15, and 30 minutes and 1, 2, 4, 6, 8, 10, 12, 14, 16 hours after injection till effect lasts. Systolic and diastolic blood pressures and heart rate were recorded before injection and at 15, and 30 minutes, 1, 2, 4, 6, 8, 10, 12, 14 and 16 hours after injection. Results: Onset of analgesia was 15min in group III where as it was 30min in group II and control group do not show any analgesia. Quality of analgesia was much better in group III. Mean duration of analgesia was 14.5hrs in group III and it was 8.2hrs in group II. Conclusions: To conclude, clonidine is a good adjuvant to 0.5% bupivacaine in interpleural block for postoperative analgesia in cases of laparoscopic cholecystectomy.