Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
83
Views
6
Downloads
Effect of Dexmedetomidine Infusion on Perioperative Hemodynamic Stability in Patients Undergoing Laparoscopic Cholecystectomy: A Placebo Controlled, Randomised Blinded Study
Dikshita Goswami, Pallavi Ghose and Aldiona Shanpru Bhattacharyya
Page: 505-510 | Received 25 Aug 2024, Published online: 07 Jan 2025
Full Text Reference XML File PDF File
Abstract
Laparoscopic surgery induces significant alterations of hemodynamic characterized by increased arterial pressure and elevation of systemic and pulmonary vascular resistance. Although these changes may be well tolerated in patients without any other comorbidities, however the tolerance is questionable in extremes of age and in cardiac patients. Suppressing the most refractory response, hypertension and tachycardia, to the most profound stimulus, intubation requires more opiod and hypnotic. In recent years α2 agonists have gained wide acceptance in anaesthetic practice due to their sedative, anxiolytic, sympatholytic and analgesic sparing properties. Dexmedetomidine is a selective α2 agonist with 8 times more affinity for α2 receptors than clonidine and possess all the properties of α2 agonist without respiratory depression (41). The primary objective was to evaluate the effect of dexmedetomidine infusion on hemodynamic stability in response to the following events in patients undergoing laparoscopic cholecystectomy: laryngoscopy and endotracheal intubation, creation of pneumoperitoneum and extubation. The secondary objective was to observe the effects on level of analgesia in immediate post operative period, level of sedation at the end of surgery, occurrence of any adverse effects, other relevant findings, if any. A placebo controlled, randomised blinded study was conducted under the Department of Anaesthesiology and Critical Care, Gauhati Medical College and Hospital, Guwahati. 60 patients were divided into two groups of 30 each. Group A received normal saline 0.9% and Group B receiving Dexmedetomidine infusion 0.4 mcg/kg/hr. Infusion of study drug was started 10 minutes prior to induction. The same general anaesthesia technique was used in all cases. Hemodynamic parameters: Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) and SpO2 were recorded at 1 minute after intubation, after pneumoperitoneum at 1 min, 15min, 30 min, 45 min and 60 min and at 1 min after extubation. All the patients were observed for one hour postoperatively in the holding area outside of the operating room. The Visual Analogue Scale (VAS) score for post operative pain and Ramsay Sedation Score were noted. The statistical analysis was done using PSW software version 21.0. Chi square test, unpaired t test, Mann Whitney test were used to determine p value. There was no significant difference in the age distribution, sex, ASA physical status, duration of surgery between both the groups. However there was significant difference in the hemodynamic parameters between the two groups. There is better stability of heart rate in the Dexmedetomidine group in the perioperative period in comparison to Normal Saline group.
How to cite this article:
Dikshita Goswami, Pallavi Ghose and Aldiona Shanpru Bhattacharyya. Effect of Dexmedetomidine Infusion on Perioperative Hemodynamic Stability in Patients Undergoing Laparoscopic Cholecystectomy: A Placebo Controlled, Randomised Blinded Study.
DOI: https://doi.org/10.36478/10.36478/makrjms.2025.1.505.510
URL: https://www.makhillpublications.co/view-article/1815-9346/10.36478/makrjms.2025.1.505.510