title: Intraperitoneal Levobupivacaine with or without Clonidine for Pain Relief after Laparoscopic Cholecystectomy: A Randomized, Double-blind, Placebo-controlled Trial.
abstract: BACKGROUND
  Irrigation of local anesthetic intraperitoneally in combination with opioids and non-opioids agents has been used to provide pain relief with varying success in laparoscopic surgeries. This randomized double blind placebo controlled study is designed to study the effect of intraperitoneal instillation of levo-bupivacaine along with clonidine for pain relief after laparascopic cholecystectomy.
  
  
  METHODS
  75 patients were randomized to receive 20 ml of 0.9% normal saline as placebo (group I), 20 ml of 0.5% levo bupivacaine (group II) and 20 ml of 0.5% levo bupivacaine with 1mcg/kg clonidine (group III) intraperitoneally. The degree of postoperative pain was assessed using the VAS and VRS on the immediate arrival in the recovery room after surgery and thereafter at 2, 4, 8, 12 and 24 hours, postoperatively. Statistical analysis was performed with ANOVA, the Kruskal-Wallis test followed by the Wilcoxon matched pairs rank test was used andP< 0.05 were considered significant.
  
  
  RESULTS
  VAS was maximum in placebo (group I) than in levobupivacaine alone (group II) and was minimum in levobupivacaine with clonidine (group III) at all time intervals. The difference between group I and II is statistically significant at immediate and at 2 hours postoperatively but no difference were found between group I and II after 2 hour. However, there is statistically significant difference (P< 0.05) between group I and III and group II and III at all time intervals.
  
  
  CONCLUSIONS
  Intraperitoneal instillation of levobupivacaine along with clonidine in a dose of 1mcg/kg is superior to levobupivacaine alone without having any significant adverse effects.
authors.affiliation: Department of Anesthesiology, SGRRIM and HS, Dehradun, Uttarakhand, India.
authors.forename: Nishith
authors.initials: N
authors.lastname: Govil
authors.affiliation: Department of Anesthesiology, SGRRIM and HS, Dehradun, Uttarakhand, India.
authors.forename: Parag
authors.initials: P
authors.lastname: Kumar
keywords: Clonidine; intraperitoneal levobupivacaine; laparoscopic cholecystectomy