Background and Aims Postoperative pain remains one of the most common challenges following laparoscopic oesophagectomy.Dexmedetomidine, an alpha-2 agonist, has intrinsic antinociceptive and antihyperalgesic properties that may reduce postoperative pain.Furthermore, there is evidence that its use during general anesthesia, as an adjuvant agent, improves pain outcomes.The aim of this study was to assess if intraoperative dexmedetomidine reduces postoperative pain scores and opioid consumption in patients undergoing laparoscopic Ivor-Lewis oesophagectomy.

Methods 30 patients undergoing laparoscopic oesophagectomy under general anesthesia were included in this retrospective observational study.We compared the effects on postoperative pain and opioid consumption in patients who received intraoperative dexmedetomidine infusion (15 patients) and those who did not. (15 patients).Postoperative pain was assessed on the PACU and on the POD1 and POD2 using the Visual Analogue Scale (VAS). Adequate pain control was defined as a VAS ≤ 4.Data on We also compared intraoperative hemodynamic instability, and postoperative nausea and vomiting (PONV) were also compared.

Results No differences in opioid requirements were found between groups (p=0.42), with a mean opioid consumption of 0.73 ± 1.56 morphine mg equivalents in patients who received dexmedetomidine, and 0.91 ± 2.39 morphine mg equivalents in the control group. We did not find statistically significant differences in postoperative pain severity (p=0.25), intraoperative hypotension (p=0.09), PONV (p=0.18), anesthetic complications (p=0.62) nor length of hospitalization (p=0.11) between groups.However, patients exposed to dexmedetomidine infusion had a greater incidence of bradycardia (OR=2.02;95% CI .16 - 3.55; p=0.007).

Conclusions Intraoperative dexmedetomidine had no effect on reducing postoperative pain scores nor opioid consumption.It was associates with a greater incidence of intraoperative bradycardia.