Research Journal of Medical Sciences
ISSN: Online 1993-6095ISSN: Print 1815-9346
Abstract
Since the first clinical anesthesia demonstration in the 1840s, the level of anesthesia has changed continuously. Hypnotic (unconsciousness) and analgesic (pain reduction) elements can be used to characterize anaesthesia. The suppression of the clinical responses to unpleasant stimuli can be used to define the level of anesthesia. To compare the effects of Magnesium sulphate (MgSO4) and Dexmedetomidine as adjuncts to anaesthetics in respect to anaesthetic consumption, intraoperative hemodynamics and postoperative recovery. This randomized, prospective, double‐blinded trial was done in Bankura Sammilani Medical from January 2012 to June 2013. Seventy female patients of 20‐60 years of age and ASA physical status I and II, undergoing elective open cholecystectomy were randomly allocated into two groups: magnesium sulphate (M) group and dexmedetomidine (D) group. Monitors were attached to the patients and baseline vital parameters (i.e., SBP, DBP, MAP, HR, SPO2, temperature) were recorded. The depth of anaesthesia (DOA) was planned to be monitored with A‐2000 BIS monitoring system, targeted at 40‐60 forsurgical anaesthesia. The patients were randomly allocated into one of the 2 groups by opening sealed envelope. A bolus dose of MgSO4 (30 mg kg-1 in 100 mL of 0.9% NS) in group M or a bolus dose of Dexmedetomidine (1 μg kg-1 in 100 mL of 0.9% NS) in group D was administered intravenously before induction over 10‐15 min. Inj. MgSO4 1 g and inj. Dexmedetomidine 50 μg were diluted with 0.9% sodium chloride to form 50 ml solution and this infusion was initiated at rate of 0.5 mL kg-1 hr-1, where the infusion dose were 10 and 0.5 μg kg-1 hr-1 for MgSO4 and Dexmedetomidine respectively. In terms of age, body weight, height and length of operation, both groups were comparable. Both groups successfully maintained their intraoperative hemodynamic profiles, however group D did so better than group M in terms of HR, SBP, DBP and MAP. Both groups' hemodynamic profiles slightly improved in the post‐intubation interval. In comparison to group M, group D experienced a substantial decrease in postoperative hemodynamic parameters for HR, SBP, DBP and MAP (p<0.0001). Propofol and sevoflurane consumption in group D was considerably lower than in group M (p<0.0001). Additionally, group D had considerably shorter induction and recovery times than group M (p<0.0001). In comparison to group M, group D's VAS score was significantly lower (p<0.0001). Dexmedetomidine, in comparison to magnesium sulphate, is a good anesthetic adjunct that reduces the need for anesthetics (propofol and sevoflurane) and analgesics (fentanyl), shortens the induction period and recovery period, attenuates sympathoadrenal responses, maintains stable hemodynamics and adequate depth of anesthesia and provides better postoperative analgesia and excellent recovery profiles.
How to cite this article:
Debaleena Jana and Sudipta Pal. BI‐Spectral Index (BIS) Guided Comparison of Magnesium Sulphate and Dexmedetomidine as
Anaesthetic Adjunct in Elective Cholecystectomy.
DOI: https://doi.org/10.36478/10.59218/makrjms.2023.401.405
URL: https://www.makhillpublications.co/view-article/1815-9346/10.59218/makrjms.2023.401.405