Abstract :
Background and Aims: The advent of laparoscopic surgery has benefited the patient and surgeon; however
creation of pneumoperitoneum for same has bearings during the perioperative period. These effects of
pneumoperitoneum are associated with significant hemodynamic changes, increasing the morbidity of the
patient. Dexmedetomidine, a newa2 agonist provides stable hemodynamic condition, good quality of intra
operative analgesia and prolonged post-operative analgesia with minimal side effects.
Materials and Methods: A total of 74 patients of either sex, planned for laparoscopic cholecystectomy
were included. The patients were randomly divided into two groups of 37 each. GROUP D received
Injection Dexmeditomedine 5mg (0.05ml) is diluted in 0.5ml of cerebrospinal fluid and injected
intrathecally. A 5minutes interval is given for recording of post injection hemodynamic parameters prior
to general anaesthesia. Patients will be premedicated with Injection glycopyrrolate 0.04 mg/kg, Injection
midazolam 0.02 mg/kg and Injection Fentanyl 2mg/kg intravenously. After adequate preoxygenation,
conventional general anaesthesia will be given to the patients. GROUP ‘E’: Conventional general
anaesthesia alone.
Measurements: Heart rate (HR), systolic blood pressure, diastolic blood pressure and mean
arterial pressure (MAP), ETco2 were recorded preoperative, after study drug, after induction, after
pneumoperitoneum at 5 min intervals, post pneumoperitoneum
Results: In group D, there was no statistically significant increase in HR and blood pressure after
pneumoperitoneum at any time intervals and there was significant increase in time for first rescue analgesic,
intraoperative fentanyl requirement, whereas in Group E, there was a statistical significant increase in MAP
after pneumoperitoneum at 5, 10 and 15 min and HR during the whole pneumoperitoneum period.
Conclusion: Dexmedetomidine 5 mg given intrathecally improves the hemodynamic stability, decreased
intraoperative requirement of fentanyl and the duration of postoperative analgesia and also provides an
analgesic sparing effect in patients undergoing laparoscopic abdominal surgery.
Keyword :
Dexmeditomedine, Intrathecal, a2 agonist, Laparoscopic surgery.