Comparison of Intravenous Dexmedetomidine and Lidocaine infusion for Perioperative Analgesic Consumption in Patient’s Undergoing Laparoscopic Gynaecological Surgeries: A Randomized Study

All patients will be familiarised about 10-point Visual Analog Scale (VAS) during the preanesthetic visit.On the day of surgery, all ASA standard monitoring will be applied, and two 18 G intravenous cannula will be secured.Baseline parameters will be noted heart rate, Systolic blood pressure, Diastolic blood pressure,Mean arterial pressure SpO2, Bispectral index etc. Balanced salt solution will be connected inone of the 18 G intravenous cannula.All patients will be premedicated with intravenous glycopyrrolate 4 mcg/Kg. Study drug bolus infusion over 10 min will be started as per group allocation (Group D or Group L). After this initial bolus infusion, general anesthesia will then be instituted with Inj.Ketamine 0.5mg/Kg, Inj.Propool 1.5-2 mg/Kg till the loss of verbal command is commenced, Inj.Rouronium 0.6 mg/Kg intravenous and endotracheal intubation will be performed after 3 min.Afterwards maintenance dose of the study drug and Inj.Ketamine infusion of 0.25 mg/Kg/hr will be started. General anesthesia will be maintained with oxygen/air/sevoflurane mixture, intermittent boluses of Inj.Rocuronium to maintain Bispectral index of 40-60.Pre-emptive intravenous Diclofenac 75 mg, Inj.Dexamethasone 0.1mg/Kg will be administered post intubation. Hemodynamic parameters,BIS, will be recorded at baseline, before the start of study infusion drugs,10 min after starting the infusion of study drug, immediately after induction, during laryngoscopy and tracheal intubation, immediately prior and after pneumoperitonium creation, and then every 15 min,till the end of surgery.As per the standard protocol Intra operative management include treating hypotension and bradycardia with appropriate and total intra operative fentanyl requirements will be noted.Infusions of the study drug and ketamine will be discontinued upon release of pneumoperitonium and trocar removal and Inj.Ondanstron 4 mg, Inj.Paracetamol 1 gm will be given and continued every 8th hourly afterwards.Residual neuromuscular blockade will be reversed following completion of surgery.After successful tracheal extubation , patients will be transferred to PACU for further monitoring. The time from skin incision to completion of skin closure will be noted and the duration of surgery will be calculated in minutes. The total duration of anesthesia from the time of commencement of infusion of study drugs till tracheal extubation will also be calculated in minutes.Time from stoppage of infusions and tracheal extubation will be noted in minutes.