ABSTRACT
Introduction: Laparoscopic cholecystectomy is one of thecommonest surgery performed under general anesthesiain our set up but maintaining the hemodynamic stability ischallenging in these patients .Due to its well-known advantageslike less post-operative pain, shorter hospitalization and fasterfunctional recovery, laparoscopic cholecystectomy is alsotermed as patient friendly surgery. The Dexmedetomidine isa relatively new potent and highly selective α2-adrenoceptoragonist that has been used to provide sympatholysis,analgesia and sedation in the perioperative period. Thepresent prospective, randomized study was designed toanalyse the effect of IV dexmedetomedine on intraoperativehemodynamics, and the incidence of side effects in patientsscheduled for laparoscopic cholecystectomy.Material and methods: After obtaining approval fromHospital Ethics Committee, Study was conducted on 80 adultpatients aged 18-60 years, of ASA grade I or II of either sex,scheduled for laparoscopic cholecystectomy under generalanesthesia. Patients were randomized into two groups of 40patients each. Patients of Group D received dexmedetomedineinfusion (loading: 0.7μg/kg and maintenance: 0.4μg/kg/hr)and Group C (control group) received normal saline infusionwith the same rate as group D. Patients were monitored forchanges in heart rate, ECG, systemic blood pressure andEtCO2, at baseline, at 5 min and 10 min after giving studydrug bolus, after induction, intubation, skin incision and CO2insufflation. Thereafter, these changes were recorded at 15min intervals till the end of surgeryResults: It was found that dexmedetomidine significantlyreduces heart rate, systolic, diastolic and mean arterialblood pressure .It was observed that perioperative use ofdexmedetomidine infusion maintained better hemodynamicstability as compared to the normal saline in control groupand has sparing effect on other anaesthetic drug mainly onproppfol and fentanyl.Conclusion: Dexmedetomidine infusion was a betteroption for maintaining hemodynamic stability duringlaparoscopic surgeries. Dexmedetomidine effectivelyattenuates haemodynamic stress response during laparoscopiccholecystectomy with reduction in requirement ofconcomitantly-administered anaesthesia maintaining drugs.
ABSTRACT
Introduction: This randomized placebo controlled study wasdesigned to evaluate the effectiveness of magnesium sulphateas an agent to induce hypotensive anaesthesia in lumbar spinesurgery.Material and Methods: The study included 100 patients ofboth sexes who were equally distributed in two groups, theGroup Mg(Magnesium sulphate group) and Group C (controlgroup). The Magnesium group received magnesium sulphate40mg/kg administered as a slow IV bolus over a period of 10minutes before induction and 15mg/kg/hr by continuous IVinfusion during surgery. The same volume of isotonic salinewas administered to the control group. Surgical time, heartrate and mean arterial blood pressure was measured.Results: In the magnesium group there was reduction insurgical time (103.54 mins vs 117.34 mins), although theanaesthestic time was 9 minutes longer in the Magnesiumgroup denoting a longer emergence time. The mean arterialpressure and heart rate were significantly reduced inMagnesium group(p<0.005). Postoperative shivering was alsoless in Magnesium group.Conclusion: Magnesium infusion resulted in a steady andsmooth reduction in mean blood pressure and reduced heartrate, with no episodes of severe hypotension. Furthermoremagnesium causes reduction in duration of surgical time andpostoperative shivering