Abstract :
Background: Dexmedetomidine is a highly selective ?2 agonist with dose-dependent sedative,
sympatholytic and analgesic properties and hence, it has combined anesthetic and analgesic
sparing effect, making it an ideal anesthetic adjuvant. The aim of this study was to evaluate
the effect of two different doses of dexmedetomidine infusion on hemodynamic response to
critical incidences such as laryngoscopy, endotracheal intubation, creation of
pneumoperitoneum and extubation in patients undergoing laparoscopic cholecystectomy.
Methods: Sixty patients of American Society of Anesthesiologists (ASA) physical grades I and II
undergoing laparoscopic cholecystectomy were randomly allocated into three groups of 20
patients each. Group NS patients received normal saline, group Dex 0.3 and group Dex 0.6
patients received loading dexmedetomidine infusion at 0.5 mcg/kg for 15 min before
induction, followed by maintenance infusion at a rate of 0.3 mcg/kg/hr and 0.6 mcg/kg/hr
respectively, continued till the end of surgery. Heart rate and mean arterial pressure (MAP)
were noted preoperative, after bolus drug administration, 1 min after induction, 1 min after
intubation, and after pneumoperitoneum at 15 min interval till the end of
pneumoperitoneum and postoperative period. SPSS 17.0 version software was used for
statistical analysis.
Results: In group NS significant hemodynamic stress response was seen following
laryngoscopy, tracheal intubation, creation of pneumoperitoneum and extubation. In both
groups of dexmedetomidine, the hemodynamic response at all times was attenuated
significantly. The results, however, were statistically better in Dex 0.6 group compared with
Dex 0.3 group.
Conclusion:Dexmedetomidine infusion effectively attenuates hemodynamic stress response
during laparoscopic surgery, but in a dose-dependent manner.
Keyword :
Dexmedetomidine, Hemodynamics, Laparoscopic cholecystectomy