Effect of intrathecal dexmedetomidine on shoulder tip pain during laparoscopic ovarian cystectomy under spinal anaesthesia

Abstract

Background: Shoulder pain secondary to laparoscopic interventions may cause more discomfort to the patient than the incision site pain, with a reported incidence varies from 35% to 80%. Aim of the study:–To evaluate the effect of intrathecal dexmedetomidine on incidence and severity of laparoscopy-triggered shoulder tip pain. Methods: Sixty patients, 1st patient recruited on the 1 July 2017, undergoing elective laparoscopic ovarian cystectomy under spinal anesthesia were randomly allocated to one of the two groups. Group C received intrathecal hyperbaric Bupivacaine 3.5 ml plus 0.5 ml normal saline. Group D received intrathecal hyperbaric Bupivacaine 3.5 ml plus 10 μg dexmedetomidine (0.5 ml). Measurements: Data on the severity of intraoperative shoulder pain were collected using a visual analogue scale. Results: Twenty-four patients in Group C complained of intraoperative shoulder tip pain, 16 patients (53.3%) required fentanyl which was given in 25 μg increments, and total fentanyl consumption for 16 patients was 875 μg. Two patients were converted into general anaesthesia as pain was intolerable (≥ 4). In Group D, five patients (16.7%) experienced shoulder pain intraoperative with a mean VAS score 0.37 ± 0.9. Conclusion: Intrathecal dexmedetomidine can effectively decrease the incidence and severity of shoulder tip pain during laparoscopic ovarian cystectomy under spinal anesthesia.