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This study aimed to assess the efficiency of dexmedetomidine against magnesium sulfate as adjuvants to intraperitoneal bupivacaine for postoperative analgesia in individuals having elective laparoscopic cholecystectomy.
Pain after laparoscopy is less intense than after laparotomy, but laparoscopy is not pain free and analgesia after this type of surgery is inadequately studied. Intraperitoneal (IP) instillation/nebulization of local anesthetics has been used as a method for reducing postoperative pain and opioid use following laparoscopy through acting on visceral nociceptors of the peritoneum.
Bupivacaine is indicated for local infiltration, peripheral nerve block, sympathetic nerve block, and epidural and caudal blocks. It is available mixed with a small amount of epinephrine to increase the duration of its action. It typically begins working within 15 minutes and lasts for 2 to 8 hours.
Dexmedetomidine is a selective alpha-2 (α2) adrenergic agonist known to have analgesic and sedative characteristics that can augment the duration of action of local anesthetics.
Magnesium is an N-methyl-D-aspartate receptor antagonist in addition to its effects on calcium influx. The anti-inflammatory and opioid-sparing effects make it a popular component of opioid free anaesthesia. It is extensively used for perioperative analgesia in a dose of 30- to 50-mg/kg intravascular bolus followed by a 10- to 15-mg/kg/h infusion.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Bupivacaine group | Active Comparator | Patients received intraperitoneal bupivacaine only at the end of the operations. |
|
| Dexmedetomidine group | Experimental | Patients received intraperitoneal bupivacaine plus dexmedetomidine at the end of the operations. |
|
| Magnesium group | Experimental | Patients received intraperitoneal bupivacaine plus magnesium sulfate at the end of the operations. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Bupivacaine | Drug | Patients received intraperitoneal bupivacaine only at the end of the operations. |
|
| Measure | Description | Time Frame |
|---|---|---|
| Degree of pain | Degree of pain was assessed using the numerical rating score (NRS) (from 0 = no pain, to 10 = the most severe pain).NRS was assessed at 1, 2, 4, 8, 16, and 24 hours postoperative. | 24 hours postoperatively |
| Measure | Description | Time Frame |
|---|---|---|
| Time to the first rescue analgesia request | Time to the first rescue analgesia request (time from the end of surgery till first dose of morphine administrated) | 24 hours postoperatively |
| Total morphine consumption |
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Inclusion Criteria:
Exclusion Criteria:
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| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Tanta University | Tanta | El-Gharbia | 31527 | Egypt |
The data will be available upon a reasonable request from the corresponding author after the end of study for one year.
After the end of study for one year.
The data will be available upon a reasonable request from the corresponding author.
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| Dexmedetomidine | Drug | Patients received intraperitoneal bupivacaine plus dexmedetomidine at the end of the operations. |
|
| Magnesium sulfate | Drug | Patients received intraperitoneal bupivacaine plus magnesium sulfate at the end of the operations. |
|
If Numerical rating score (NRS)-S >4, IV 3 mg morphine was given as a rescue analgesia.
| 24 hours postoperatively |
| Level of sedation | Level of sedation using Ramsey scale at 1, 2, 4, 8, 16, and 24 hours postoperative from 1 to 6:
| 24 hours postoperatively |
| Lenght of hospital stay | Length of hospital stay was recorded from admission till discharge from hospital. | 1 week postoperatively |
| ID | Term |
|---|---|
| D002045 | Bupivacaine |
| D020927 | Dexmedetomidine |
| D008278 | Magnesium Sulfate |
| ID | Term |
|---|---|
| D000813 | Anilides |
| D000577 | Amides |
| D009930 | Organic Chemicals |
| D000814 | Aniline Compounds |
| D000588 | Amines |
| D007093 | Imidazoles |
| D001393 | Azoles |
| D006573 | Heterocyclic Compounds, 1-Ring |
| D006571 | Heterocyclic Compounds |
| D017616 | Magnesium Compounds |
| D007287 | Inorganic Chemicals |
| D013431 | Sulfates |
| D013464 | Sulfuric Acids |
| D013456 | Sulfur Acids |
| D013457 | Sulfur Compounds |
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