To Evaluate the Effectiveness of Intravenous Dexmedetomidine Infusion During Laproscopic Cholecystectomy. A Prospective Randomised Placebo Control Study

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.