ABSTRACT : Compare quality of analgesia with regard to visual analogue scale for pain. To compare duration of post-operative analgesia after intra peritoneal instillation of bupivacaine, bupivacaine plus tramadol and bupivacaine plus dexmedetomidine. To compare changes in mean arterial pressure after the administration of the drugs.

METHODS : 80 patients undergoing laparoscopic cholecystectomy were randomized in one of four groups: Group C received 20 ml of saline, Group S received 20 ml of 0.25% bupivacaine containing Group T received 20 ml of 0.25% bupivacaine with 100 mg, tramadol patients allocated to Group D received 20 ml of 0.25% bupivacaine with 50micrograms of dexmedetomidineintraperitoneally. Visual analogue scale was recorded at 1, 2, 4, 6 and 24 hours postoperatively. Incidence of postoperative nausea and vomiting (PONV) was also recorded. In addition, supplementary analgesic and anti-emetic consumption were assessed.

RESULTS : Pain intensity, PONV as well as postoperative supplementary medications were significantly lower in Group D, Group T and Group S than in Group C. There were no differences between the three groups receiving bupivacaine and bupivacaine with tramadol and bupivacaine with dexmedetomidine in VAS score, incidence of nausea and vomiting and postoperative analgesic and anti-emetic consumption.

CONCLUSIONS : Intraperitoneal instillation of bupivacaine with tramadol, bupivacaine with dexmedetomidine and bupivacaine is an effective method for management of postoperative pain after laparoscopic cholecystectomy. It significantly reduced supplementary postoperative analgesic and anti-emetic medication.