Effects of Dexmedetomidine on Intraoperative Hemodynamic Responses in Patients Undergoing Laparoscopic Cholecystectomy: A Randomised Double Blind Trial

Dexmedetomidine is a highly selective alpha 2 agonist with dose dependent sedative sympatholytic analgesic properties and is used as an anaesthetic adjuvant. We have evaluated the effect of dexmedetomidine on hemodynamic responses to critical incidences such as laryngoscopy, endotracheal intubation, creation of pneumoperitoneum and extubation in patients undergoing laparoscopic cholecytectomy.We have used a loading dose of 0.5mcg/kg over 10 minutes followed by infusion of 0.3mcg/kg/hour for the control of hemodynamic response to laparoscopy.

Patient of either sex aged between 18-50 yrs, belonging to ASA (American society of anaesthesiology) I and II posted for laparoscopic cholecystectomy were included. Institutional ethical committee clearance was obtained prior to study. After enrolment written valid consent was taken. 60 patients were enrolled and a written valid informed consent was taken. The patients were divided into two groups 30 each with computerized randomization. Base line parameters were noted. Observer and patient was blinded for the content of syringe. Group A received injection dexmedetomidine and group B received bolus and infusion of normal saline at same rate. Routine general anaesthesia was instituted. Parameters were noted after induction, after intubation, after co2 insufflation, after 20 min, after 40 min, after co2 deflation, after extubation, after 1 and 2 hrs post-extubation.

Group A showed significantly less rise in HR and MAP than Group B. Requirement of intraoperative propofol was more in Group B. There was no significant difference for time taken to awakening in both groups.

We found Injection Dexmedetomidine in given doses gave good hemodynamic control with minimal undesired effects during laparoscopy.