Background: shoulder pain secondary to laparoscopic interventions may cause more discomfort to the patient than the incision site pain, with a reported incidence varies from 35% to 80%.

Aim of the study: - Evaluate the effect of intrathecal dexmedetomidine on incidence and severity of  laparoscopy-triggered shoulder tip pain.

 Methods: Sixty patients, 1st patient recruited on the 1st of July 2017, undergoing elective laparoscopic ovarian cystectomy under spinal anesthesia were randomly allocated into one of two groups. Group C: received intrathecal hyperbaric Bupivacaine 3.5 ml plus 0.5 ml normal saline. Group D: received intrathecal hyperbaric Bupivacaine 3.5 ml plus 10 μg dexmedetomidine (0.5 ml). Measurements: Data on the severity of intraoperative shoulder pain was collected using visual analogue scale.

 Results: Twenty-four patients in Group C, the complaint of intraoperative shoulder tip pain, 16 patients (53.3%) required fentanyl which was given in 25 μg increments and total fentanyl consumption for 16 patients was 875 μg. Two patients were converted into general anaesthesia as pain was intolerable (≥ 4). In Group D, five patients (16.7%) experienced shoulder pain intraoperative with a mean VAS score 0.37± 0.9.

Conclusion: intrathecal dexmedetomidine can effectively decrease the incidence and severity of shoulder tip pain during laparoscopic ovarian cystectomy under spinal anesthesia.

Keywords: Dexmedetomidine, Laparoscopy, Spinal anesthesia, shoulder tip pain.