Intraperitoneal installation of bupivacaine with either dexmedetomidine or ketamine for postoperative analgesia after laparoscopic sleeve gastrectomy: A randomized controlled study

Q2 Nursing

Perioperative Care and Operating Room Management Pub Date : 2025-02-05 DOI:10.1016/j.pcorm.2025.100481

Asmaa M. Galal Eldin, Abeer M. Elnakera, Rehab A. Wahdan

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引用次数: 0

Abstract

Background

Postoperative pain management after laparoscopic sleeve gastrectomy is still considered a major challenge. The current study was designed to assess if adding ketamine or dexmedetomidine to intraperitoneal bupivacaine could improve the quality and the duration of postoperative analgesia for morbidly obese patients undergoing laparoscopic sleeve gastrectomy.

Methods

Sixty patients scheduled for elective laparoscopic sleeve gastrectomy were randomly assigned to receive intraperitoneal instillation of bupivacaine (0.25 %) alone (group C), bupivacaine (0.25 %)/ketamine 0.5 mg/kg (group K) or bupivacaine (0.25 %)/dexmedetomidine 1µg/kg (group D) after sleeve gastrectomy. The primary outcome measured was the time to first postoperative rescue analgesia. Secondary outcomes included postoperative analgesic requirements, postoperative pain intensity measured by the Visual Analog Scale (VAS) and the incidence of shoulder pain.

Results

The time to first rescue analgesia was significantly longer (< 0.001) and the total amount of postoperative nalbuphine required was significantly lower in both the K and D groups (< 0.001) compared to the C group. Additionally, the time to first rescue analgesia was significantly longer in group D compared to group K. The VAS score was significantly lower in groups K and D compared to group C (P < 0.05) at most measuring points, with no significant difference between groups K and D. The incidence of postoperative shoulder pain was significantly higher in group C compared to groups K and D (< 0.001) with no statistically significant difference between groups K and D.

Conclusion

Adding either ketamine 0.5 mg/kg or dexmedetomidine 1µg/kg to intraperitoneal bupivacaine 0.25 % can safely improve postoperative analgesia resulting in a longer time to first rescue analgesia, lower VAS for pain values, reduced postoperative rescue analgesic requirements in the first postoperative 24 h and a lower incidence of postoperative shoulder pain.

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来源期刊

Perioperative Care and Operating Room Management Nursing-Medical and Surgical Nursing

CiteScore

1.30

自引率

0.00%

发文量

审稿时长

56 days

期刊介绍： The objective of this new online journal is to serve as a multidisciplinary, peer-reviewed source of information related to the administrative, economic, operational, safety, and quality aspects of the ambulatory and in-patient operating room and interventional procedural processes. The journal will provide high-quality information and research findings on operational and system-based approaches to ensure safe, coordinated, and high-value periprocedural care. With the current focus on value in health care it is essential that there is a venue for researchers to publish articles on quality improvement process initiatives, process flow modeling, information management, efficient design, cost improvement, use of novel technologies, and management.