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Original Research Article Background: Abdominal hysterectomy is a common and major surgery associated with moderate to severe pain. Various short and long term complications may occur if the pain is treated inadequately. Different drugs and interventions are currently being practiced for adequate pain management. Among them, preemptive analgesia was adopted with the aim to reduce the dose of opioid by preventing central sensitization. Thereby, avoiding dose related side effects despite providing adequate analgesia. The dexmedetomidine, a highly potent 2 agonist with several perioperative beneficial properties, was investigated for its status as preemptive analgesic. Objective: The present study was designed to evaluate the role of preemptive dexmedetomidine on postoperative analgesia following open abdominal hysterectomy under general anaesthesia. Methods: Forty ASA I and II, aged more than 18 years patients, undergoing open abdominal hysterectomy were allocated into 2 equal groups (n=20 in each group) by a computergenerated randomization table. Group A and B received equal volumetric (0.25ml/kg) dexmedetomidine and normal saline respectively, 20 minutes prior to induction of general anaesthesia. VAS and PCA morphine consumption, heart rate, mean arterial pressure and capillary oxygen saturation was recorded at defined postoperative time points and adverse effects were noted. Results: The total amount of postoperative morphine requirement after 24 hours was 30.98±1.15 mg in group A and 32.15±2.16 mg in Group B (p value=0.039) which is significantly higher in group B. The group A had significantly lower VAS score in both the resting (P= 0.001, 0.001, 0.019, 0.010and 0.042) and movement state (P = 0.001, 0.006, 0.007, 0.029 and 0.035) for time points of 1 st , 2 nd , 6 th , 12 th and 24 th hours postoperatively, compared to the group A. Furthermore, we observed, there was significant obtundation of HR and MAP, evoked by intubation and extubation in group A. Similar response was seen just after extubation. HR was significantly (P<0.05) lower in group A at all postoperative follow up. Additionally, group A had lower MAP compared to group B. The opioid related adverse events were slightly lower in dexmedetomidine group. Conclusion: Preemptive use of intravenous dexmedetomidine reduced postoperative pain intensity, opioid requirement and rendered better haemodynamic stability.

scholars journal of applied medical sciences

Role of Dexmedetomidine as Preemptive Analgesic on Postoperative Pain Following Open Abdominal Hysterectomy under General Anaesthesia: A Placebo Controlled Study