The Impact of Intraperitoneal Dexmedetomidine with Bupivacaine on Patients’ Postoperative Pain in Endometriosis Laparoscopic Surgery; A Randomized, Clinical Trial

Samaneh Rokhgireh, Abolfazl Mehdizadehkashi, Mansoureh Vahdat, Zahra Najmi, Naimeh Taghavi Shoazi, Vahideh Astaraii, Mohammad Kermansaravi, Seyed Hamid Reza Faiz, Shahla Chaichian, Shahla Mirgaloy Bayat
In: Shiraz E-Medical Journal · 2019 · vol. 20(7) · doi:10.5812/semj.85296 · W2948661416
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⚙ AI-generated summary by claude@2026-06, 2026-06-10 ⓘ

Intraperitoneal dexmedetomidine plus bupivacaine significantly reduced postoperative pain scores and analgesic consumption in laparoscopic endometriosis surgery compared to bupivacaine alone.

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⚙ AI-generated deep summary by claude@2026-06, 2026-06-10 ⓘ

This randomized clinical trial compared intraperitoneal dexmedetomidine (DEX) plus bupivacaine versus bupivacaine alone and versus normal saline in patients undergoing laparoscopic surgery for endometriosis, assessing postoperative pain using VAS scores at multiple time points up to 48 hours and tracking rescue analgesic use. The DEX+bupivacaine group had significantly lower pain scores in the recovery room and at 2, 6, 12, 24, and 48 hours, with fewer rescue analgesic requirements, though the longest time to first rescue analgesia occurred in the bupivacaine-only group. The authors note limitations including a small sample size and that surgeries were not all performed by a single surgeon, despite efforts to unify surgical techniques and equipment. This paper is centrally about endometriosis — it tests intraperitoneal DEX plus bupivacaine for postoperative pain control after laparoscopic endometriosis surgery.

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Abstract

Background: Endometriosis is routinely treated with laparoscopy, which despite significant advantages over laparotomy cannot diminish postoperative pain. Insufficient postoperative pain control decreases patient satisfaction. Objectives: This study was designed to evaluate the efficacy of intraperitoneal dexmedetomidine (DEX) combined with bupivacaine on postoperative pain in endometriosis laparoscopic surgery. Methods: Fifty-three patients with endometriosis, scheduled for laparoscopy in Rasoul-e-Akram Hospital, Tehran, from January 2016 to May 2017 who were randomly divided into three groups, including group 1 (G1, n = 21) received 50 mL intraperitoneal saline, group 2 (G2, n = 16) received 50 mL intraperitoneal instillation of bupivacaine 0.25%, and group 3 (G3, n = 16) received 50 mL bupivacaine 0.25% plus dexmedetomidine 1 µg/kg. Each patient with a history of allergy to local anesthetics or dexmedetomidine, cardiac disease, renal or hepatic failure, severe pulmonary disease; in addition, pregnant and comorbid obese patients were excluded from the study. Patients’ postoperative pain was assessed in the recovery room after 2, 6, 12, 24, and 48 hours using visual analogue scale (VAS). Total analgesic consumption was also recorded. Results: The postoperative VAS scores were significantly lower in group 3 than other groups in the recovery room, and 2, 6, 12, 24 and 48 hours after the surgery (P < 0.001). However, there was no significant difference between 1 and 2 groups. Furthermore, total VAS in the first 24 hours in group 3 was significantly lower than the two other groups (P < 0.001). Conclusions: We conclude 1 μg/kg intraperitoneal DEX administration combined with bupivacaine may prolong postoperative analgesia and decrease rescue analgesia requirement compared with bupivacaine alone.

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VAS-pain

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endometriosis

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