The analgesic effects of incisional levobupivacaine with dexmedetomidine after total abdominal hysterectomy

Abstract

Objective: The purpose of this study was to assess the analgesic efficacy of dexmedetomidine added levobupivacaine applied into the wound site by infiltration in total abdominal hysterectomy. Materials and Methods: We studied 50 American Society of Anesthesiologists (ASA) physical status I–II patients scheduled for abdominal hysterectomy. The patients were randomized into two groups: infiltration of the surgical area with 0.25% levobupivacaine (40 mL) (Group L) or 0.25% levobupivacaine plus 2 mcg kg−1 dexmedetomidine (40 mL) (Group DL) 5 min before skin incision. After anesthesia induction, 5 min before surgical incision, 20 mL of the trial preparation (0.25% levobupivacaine or 0.25% levobupivacaine plus 2 mcg.kg−1 dexmedetomidine) was injected in the subcutaneus tissue along the marked line of skin incision. Another 20 mL of the same trial preparation was then infiltrated preperitoneally along the line of the planned incision of the peritoneum. Results: Total meperidine consumption was significantly lower in Group DL (p=0.003). The visual analog scale (VAS) values at resting were significantly lower at 0, 2, and 4 h (p=0.001, 0.001, and 0.003, respectively) in Group DL in the postoperative period. VAS values at coughing were lower in Group DL at postoperative 0, 2, 4, 6, and 12 h (p=0.001; 001; 0.003; 0.006; 0.008 respectively). The need for rescue analgesic was significantly high in Group L (p<0.001). Conclusion: Dexmedetomidine added to local anesthetic agent applied to the wound site reduced the analgesic consumption and improved the pain scores in total abdominal hysterectomy surgery.