Antinociceptive Effect of (α<sub>2</sub>-Adrenoceptor Agonist) Dexmedetomidine vs Meperidine, Topically, after Laparoscopic Gynecologic Surgery
ABSTRACT This prospective double blinded study compared the analgesic effect of intraperitoneal dexmedetomidine or meperidine with bupivacaine to intraperitoneal bupivacaine alone in laparoscopic gynecologic surgery. Sixty female patients undergone elective laparoscopic gynecologic surgery given a standardized general anesthesia were randomly allocated into one of three equal sized groups; Group B: intraperitoneal 50 mL bupivacaine 0.25%, Group B+M: intraperitoneal 50 mL bupivacaine 0.25%+1 mg kg-1 meperidine and Group B+D: intraperitoneal 50 mL bupivacaine 0.25%+1 μg kg-1 dexmedetomidine. The following parameters were evaluated: (1) Time to first request of analgesia, (2) The incidence and severity of postoperative shoulder pain for 24 h postoperatively, (3): The amount of postoperative PCA morphine for 24 h postoperatively. Times to first request of analgesia was significantly short in group B compared to the other 2 groups (p<0.05). Doses of intravenous PCA morphine consumed at 0-6, 6-12, 12-18, 18-24 and 0-24 h were significantly less in groups B+M and B+D compared to group B (p<0.05) with no significant difference between groups B+M and B+D. The incidence and severity of shoulder pain were less in group B+M and B+D compared to group B (p<0.05) with no significant difference between the later two groups. Intraperitoneal instillation of meperidine (1 mg kg-1) or dexmedetomidine (1 μg kg-1) in combination with bupivacaine 0.25% in female patients undergoing laparoscopic gynecologic surgery significantly decreases the postoperative analgesic requirements and decreased the incidence of shoulder pain compared to intraperitoneal bupivacaine 0.25% alone.