“Comparison of Effects of Port Site Infiltration with Dexamethasone versus Dexmedetomidine as Adjuvant to Ropivacaine on Postoperative Pain in Laparoscopic Cholecystectomy” – A Randomized Controlled Double Blinded Study

Background: Postoperative pain management is crucial after surgery. Poorly controlled postoperative pain can lead to prolonged hospital stays and patient dissatisfaction. Wound infiltration is one of the modalities of multimodal analgesia. Aim: The present randomized, controlled, double-blinded study aimed to compare the analgesic efficacy of dexamethasone and dexmedetomidine as adjuvants to ropivacaine following their infiltration at the surgical port site in patients undergoing laparoscopic cholecystectomy under general anesthesia. Methods: Participants were allocated into three groups (20 in each group): Group RS received ropivacaine and normal saline, Group RDx received ropivacaine with dexamethasone (8 mg), and Group RDm received ropivacaine with dexmedetomidine (50 μg) before surgical port closure. Postoperative pain was assessed using the Numerical Rating Scale (NRS) at 1, 3, 6, 9, 12, and 24 h postinfiltration. Results: Patients in Groups RDx and RDm experienced significantly lower pain scores at 1, 3, 6, and 9 h compared to Group RS ( P < 0.05). The mean duration of analgesia was significantly prolonged in Group RDm (567.75 ± 125.81 min) compared to Group RDx (476.25 ± 116.76 min) and Group RS (360 ± 88.79 min) ( P < 0.0001). Conclusion: It is concluded that both dexamethasone 8 mg and dexmedetomidine 50 μg may be used as an adjuvant to 0.5% ropivacaine for port site infiltration to prolong postoperative analgesia in patients undergoing laparoscopic cholecystectomy safely and effectively. However, dexmedetomidine (50 μg) provided significantly more prolonged analgesia than dexamethasone (8 mg).