Evaluation of lignocaine and dexmedetmdine infusion on recovery profile, quality of recovery and postoperative analgesia in patient undergoing total abdominal hysterectomy

Postoperative pain management aims to minimize side effects while achieving pain and discomfort reduction or elimination. The needs of each patient are taken into account when providing postoperative pain relief, which is contingent upon clinical, patient-related, and local factors. The patient's subjective assessment of pain is the ultimate determination of the extent to which pain is relieved. It has been demonstrated that using both systemic lignocaine and systemic dexmedetomidine together can effectively reduce postoperative pain and enhance the quality of recovery following surgery. To evaluate and compare the quality of recovery score (QoR 40) with perioperative infusion of lignocaine and dexmedetomidine and analgesic requirement in postoperative period with the use of perioperative infusion of lignocaine or dexmedetomidine. 135 female subjects posted for elective trans-abdominal hysterectomy under general anaesthesia were randomized to receive an infusion of Lignocaine (1.5 mg/kg over 15 minutes followed by a 2 mg/kg/h infusion until the end surgery) (Group 1) or Normal saline (10 ml over 15 minutes followed by infusion @1ml/kg/hr till the end of surgery) (Group 2) and inj. Dexmedetomidine (DEX) 1 mcg/kg over 15 minutes followed by infusion @0.6mcg/kg/hr till the end of surgery. (Group 3). Intraoperative hemodynamics, extubation variables, postoperative analgesic requirement, and quality of recovery score were evaluated. Lignocaine and dexmedetomidine infused intraoperatively preserved hemodynamics and met early extubation criteria. The duration of the first postoperative analgesic requirement as well as the total amount of analgesics needed in a 24-hour period were similar in groups 1 and 3, but significantly longer in the placebo “group 2. In Group 1, Group 2, & Group 3, the median (IQR) recovery score (QoR-40) was 184(178-191), 178(171-180), and 180(177-188). While there was no significant difference between the lignocaine and dexmedetomidine groups (p>0.209), it was significant” when compared to saline (p<0.001). The application of intraoperative lignocaine/dexmedetomidine infusions was linked to early recovery, a lower need for postoperative analgesics, and a higher Quality of Recovery score, which indicated higher levels of patient satisfaction.