Utility of intraperitoneal analgesia with Ropivacaine plus Dexmedetomidine in patients undergoing laparoscopic sleeve gastrectomy

Background: Background: A crucial aspect of anesthesiology practice is postoperative pain management, as it significantly impacts patient recovery, length of hospital stay, and healthcare costs. Intraperitoneal analgesia has gained importance in minimally invasive procedures due to its beneficial properties in postoperative pain control. Objective: This study aims to compare the incidence of nausea, vomiting, postoperative pain, and quality of recovery in patients undergoing bariatric surgery using intraperitoneal analgesia versus intravenous analgesia. Material and Methods: A total of 50 patients undergoing laparoscopic sleeve gastrectomy were included. They were divided into two groups: Group 1 (n=30) received intraperitoneal analgesia with Ropivacaine 0.75% and Dexmedetomidine, while Group 2 (n=20) received continuous intravenous analgesia with Lidocaine and Dexmedetomidine. Pain intensity (VAS scale), sedation levels (RASS scale), incidence of nausea and vomiting, and postoperative opioid consumption were assessed. Results: No significant differences were found between groups regarding pain scores at 0, 6, and 24 hours postoperatively. Similarly, there were no significant differences in the incidence of nausea and vomiting. However, the intraperitoneal analgesia group exhibited a longer duration before requiring rescue analgesia, lower opioid consumption, and lower sedation levels on the RASS scale. Conclusion: Intraperitoneal administration of Dexmedetomidine combined with Ropivacaine 0.75% in bariatric surgery is associated with prolonged analgesic effects and reduced opioid use. Although it did not significantly impact nausea or pain scores compared to intravenous analgesia, its potential benefits in multimodal pain management warrant further investigation. Keywords: Pain management, intraperitoneal analgesia.