A Comparative Study of Intraperitoneal Instillation of Tramadol or Clonidine along with Bupivacaine for Postoperative Analgesia Following Laparoscopic Cholecystectomy

Background: Laparoscopic cholecystectomy offers reduced morbidity, pain, and quicker recovery. Effective pain treatment reduces risks of complications like pulmonary embolism, deep vein thrombosis, pneumonia, and atelactasis. Bupivacaine (a local anaesthetic class of drug), has shown promising results in managing postoperative discomfort following laparoscopic cholecystectomy. Tramadol, an opioid analgesic, has been found to control moderate to severe postoperative pain in patients with day surgery and inpatients. Clonidine, an alpha-2-adrenergic analgesic, can be combined with local anaesthetics to increase sensory and motor blocking effects without causing opioid side effects. Aim: The study compares the effectiveness of bupivacaine with tramadol and bupivacaine with clonidine for postoperative analgesia in patients undergoing laparoscopic cholecystectomy. Materials and Methods: The study was a double-blind, randomized prospective investigation involving 90 patients divided into two groups (45 each group) aged 18-60 years who underwent laparoscopic cholecystectomy belonging to ASAPS 1 and 2. Group A (bupivacaine with tramadol), Group B (bupivacaine with clonidine). Hemodynamic changes and post-operative pain scores were recorded and statistical analysis performed. Results: The study found no significant differences in gender, age, ASA grade, weight, height, or operation duration between the two groups. The mean diastolic blood pressure, mean arterial pressure, and heart rate were comparable across the groups. Conclusion: The study reveals that clonidine and bupivacaine offer superior postoperative analgesia during laparoscopic cholecystectomies without significant differences in hemodynamic parameters, indicating the need for further research on optimal drug concentration.