Ketamine-Dexmedetomidine Analgesia in Laparoscopic Cholecystectomy

Abstract

Background: Even though laparoscopic cholecystectomy is a common day-care treatment, postoperative discomfort is still a major problem that causes recovery and release to be delayed. The best approach to lessen this discomfort and cut back on opiate use is multimodal analgesia.

Objective: This study's main goal was to assess the analgesic effectiveness of Ketamine plus Dexmedetomidine (Ketodex) versus Ketamine alone in individuals having elective laparoscopic cholecystectomy. Assessing the incidence of side effects, total analgesic intake, and the time to first rescue analgesia were secondary goals.

Methods: Over the course of eighteen months, a prospective, randomized, double-blind, controlled trial was carried out at the Indira Gandhi Institute of Medical Sciences (IGIMS), Patna. There were 102 patients in all (ASA I & II, ages 18–60). Patients were divided into two groups at random: Group KD got an intravenous bolus of  of ketamine and  of dexmedetomidine, while Group K received of ketamine alone, given 10 minutes before the incision. Visual Analog Scale (VAS) scores were used to measure postoperative discomfort at 24 hours.

Results: At every postoperative interval, Group KD's VAS scores were considerably lower than Group K's (). Group KD had a considerably longer mean time to first rescue analgesia ( hours) than Group K ( hours, ). Group KD consumed considerably less rescue analgesics overall ( than Group K (). On the other hand, the KD group experienced more nausea and vomiting (19.60%) than the K group (3.92%).

Conclusion: Although it is linked to an increased risk of postoperative nausea, the combination of ketamine and dexmedetomidine offers better postoperative analgesia and a notable opioid-sparing benefit when compared to ketamine alone