Comparative Study of Dexamethasone Versus Ondansetron as Adjuvants to the Intra-Peritoneal Irrigation of Bupivacaine for Reducing the Postoperative Pain in Patients Undergoing Elective Laparoscopic Cholecystectomy

Abstract

Basim Herez Ali, Ameer Zuhair Hameed, Raad Jasim Isa.

Background: Post-operative pain that follow laparoscopic cholecystectomy (LC) usually is the main complaint, also it have many benefits over open cholecystectomy in form of decrease post-operative pain, short hospital stay and better cosmetic result, but it is still painful. This study assesses the effect of intra-peritoneal irrigation of Dexamethasone and Ondansetron as adjuvant to Bupivacaine at the surgical bed to reduce post-operative pain and requirement for analgesia.
Methods and materials: This study included 75 patients underwent elective LC who prospectively randomized into 3 groups. The control group (A) (n=25) received 20 ml of bupivacaine 0.5% with 2 ml normal saline installed by the surgeon into the gallbladder bed, dexamethasone group (D) (n=25) received 20 ml of bupivacaine 0.5% and 2 ml dexamethasone (8mg) installed into the same site, ondansetron group (O), (n=25) received 20 ml of bupivacaine 0.5% and 2 ml ondansetron (4mg). Pain was assessed in 1, 3, 6, 9, 12 hours post-operatively by using visual analog scale (VAS).
Results: The pain in ondansetron group was significantly lower than the other 2 groups in 1st. 3rd, 6th and 12th hours post-operatively (P<0.001), also the pain in dexamethasone group was lower than control group.
Conclusions: In this study, the intra-peritoneal irrigation of bupivacaine with dexamethasone and ondansetron reduce the post-operative pain during the first post-operative hours after LC and also reduce the requirement for analgesia.