Effect of Two Different Doses of Dexmedetomidine on Hemodynamics in Patients undergoing Laparoscopic Surgeries under General Anesthesia - A Comparative Study

Gaurav Acharya, Shaily Gokharu, Kishore Kumar Arora, Dewesh Kumar

Abstract


Background: Dexmedetomidine is a highly selective α2 agonist with dose-dependent sedative, sympatholytic and analgesic properties and hence, it has combined anesthetic and analgesic sparing effect, making it an ideal anesthetic adjuvant. The aim of this study was to evaluate the effect of two different doses of dexmedetomidine infusion on hemodynamic response to critical incidences such as laryngoscopy, endotracheal intubation, creation of pneumoperitoneum and extubation in patients undergoing laparoscopic cholecystectomy.

Methods: Sixty patients of American Society of Anesthesiologists (ASA) physical grades I and II undergoing laparoscopic cholecystectomy were randomly allocated into three groups of 20 patients each. Group NS patients received normal saline, group Dex 0.3 and group Dex 0.6 patients received loading dexmedetomidine infusion at 0.5 mcg/kg for 15 min before induction, followed by maintenance infusion at a rate of 0.3 mcg/kg/hr and 0.6 mcg/kg/hr respectively, continued till the end of surgery. Heart rate and mean arterial pressure (MAP) were noted preoperative, after bolus drug administration, 1 min after induction, 1 min after intubation, and after pneumoperitoneum at 15 min interval till the end of pneumoperitoneum and postoperative period. SPSS 17.0 version software was used for statistical analysis.

Results: In group NS significant hemodynamic stress response was seen following laryngoscopy, tracheal intubation, creation of pneumoperitoneum and extubation. In both groups of dexmedetomidine, the hemodynamic response at all times was attenuated significantly. The results, however, were statistically better in Dex 0.6 group compared with Dex 0.3 group.

Conclusion: Dexmedetomidine infusion effectively attenuates hemodynamic stress response during laparoscopic surgery, but in a dose-dependent manner.


Keywords


Dexmedetomidine, Hemodynamics, Laparoscopic cholecystectomy.

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References


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