A Comparison of the Recovery Profile of Dexmedetomidine When Administered by Different Routes in Patients Undergoing Laparoscopic Cholecystectomy – A Randomized Controlled Trial

Abstract

Laparoscopic cholecystectomy is a minimally invasive procedure that demands a safe and fast-tracking anesthesia plan. A faster and smoother recovery of patients from anesthesia after a surgical procedure is critical for early discharge. Dexmedetomidine is a short-acting α2 agonist with analgesic, sedative, and anxiolytic properties. However, it is associated with prolonged sedation when administered through an intravenous route, thereby prolonging the recovery time from anesthesia. We conducted this study to compare the time to extubation after anesthesia when dexmedetomidine was administered through the conventional intravenous route and an interfascial transversus abdominus plane (TAP) block and rectus sheath (RS) block in patients undergoing laparoscopic cholecystectomy surgeries under general anesthesia. In addition, we also studied postoperative pain using the Visual analog scale (VAS). This study is a double-blinded, randomized controlled clinical trial conducted on 54 patients undergoing laparoscopic cholecystectomy. Patients were allocated to two groups. Group C received 50 micrograms of dexmedetomidine intravenously. Patients in group T received 50 micrograms of dexmedetomidine as an adjuvant to the 0.3% ropivacaine administered through the TAP block and RS block. The mean time for extubation in group C was 10.87 ± 1.71 minutes, and in group T was 4.37 ± 0.25 minutes, which was significant (p < 0.05, 95% CI - 5.83 to 7.17). In addition, the median postoperative VAS in group T was significantly lower at six hours, 12 hours, and 18 hours postoperatively. Hence, we conclude that dexmedetomidine, administered in the interfascial plane for laparoscopic cholecystectomy surgery, provides a better recovery profile from general anesthesia and good postoperative pain relief.