Comparison of two different doses of dexmedetomidine infusion on post-operative pain and sedation in patients undergoing laparoscopic surgery.

ABSTRACT

Background: Effective attenuation of the sympathoadrenal stress responses is an important goal in anesthesiology. Dexmedetomidine (Dex) a new generation highly selective α2 adrenoreceptor agonist might permit sedation and analgesia without the unwanted vascular effects from activation of α1 receptors. In addition, it has been shown to induce a centrally mediated reduction of sympathetic nervous system activity and decrease hemodynamic and plasma catecholamine response to stressful events. These properties theoretically make it a suitable agent for use as part of the anesthetic regimen. The aim was to study the effect of Dex infusion at two different doses on sedation and post-operative pain using Ramsay sedation score and visual analog scale (VAS) during the post-operative period for first 24 hrs. Methods: In this study, the patients were randomly divided into three different groups (control, Dex 0.3, and Dex 0.6) using computer generated random table. Post-operatively patient’s sedation pain scores were compared using Ramsay sedation score and VAS, respectively. Results: It was observed that the duration of surgery, duration of infusion and use of fentanyl (μg) was statistically insignificant in all the three groups. The mean pain in subjects of both Dex 0.3 and Dex 0.6 just after surgery till 6 hrs post-surgery were found to be significantly (p<0.01) lower when compared to control while in other periods it did not differed significantly (p>0.05) between the three groups i.e., remains statistically the same. On comparing the mean Sedation in subjects of Dex 0.3 and Dex 0.6 just after surgery till 12 hrs post-surgery were found to be significantly (p<0.05 or p<0.01) higher when compared to Control. Further, the mean Sedation in subjects of Dex 0.6 just after surgery and 2 hrs after surgery were also found to be significantly (p<0.01) higher than that of Dex 0.3. However, the mean sedation in all three groups at 18 hrs after surgery and 24 hrs after surgery remains the same i.e., did not differed significantly (p>0.05). Conclusion: The perioperative infusion of Dex may be an attractive option during laparoscopic surgery as it, offered better control of intraoperative and post-operative hemodynamics, and decreased post-operative pain level and better sedation scores, as compared with control.