Intraperitoneal Instillation of Dexmedetomidine Versus Magnesium Sulphate as Adjuvants to Bupivacaine in Laparoscopic Cholecystectomy

Laparoscopic cholecystectomy is one of the most commonly performed minimally invasive procedures worldwide. Despite its advantages over open surgery, such as shorter hospital stay and faster recovery, patients frequently experience postoperative pain, which can delay mobilization, prolong hospital stay, and reduce overall satisfaction [1]. Effective pain management is therefore a critical component of enhanced recovery after laparoscopic cholecystectomy [2].

Intraperitoneal instillation of local anesthetics has been widely used as part of multimodal analgesia to reduce postoperative pain [3]. Bupivacaine, a long-acting amide local anesthetic, is commonly employed due to its favorable safety profile and prolonged duration of action. However, when used alone, its efficacy in providing sustained analgesia is limited, prompting the exploration of adjuvants that may potentiate its effect [4].

Dexmedetomidine, a highly selective α2-adrenergic receptor agonist, has been shown to enhance the analgesic efficacy of local anesthetics by prolonging sensory blockade and providing sedative as well as opioid-sparing effects. Magnesium sulphate, an N-methyl-D-aspartate (NMDA) receptor antagonist, has also been investigated as an adjuvant, with evidence suggesting its role in reducing central sensitization and postoperative pain [5].

Aim of the work The present study aims to compare the analgesic efficacy of intraperitoneal bupivacaine combined with dexmedetomidine versus bupivacaine combined with magnesium sulphate in patients undergoing laparoscopic cholecystectomy.

Primary Outcomes: