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Effects of Dexmedetomidine Infusion on Hemodynamic Stress Response, Sedation and Post-operative Analgesic Requirement in Patients Undergoing Laparoscopic Cholecystectomy

Killu Bhagyalakshmi , Sarada Roja Madhuri1 , Killu Bhagyalakshmi2 , Malapolu Neeraja3

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Indian Journal of Anesthesia and Analgesia 6(5):p 1559-1568, September-October 2019. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.11

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Sarada Roja Madhuri, Killi Bhagyalakshmi, Malapolu Neeraja. Effects of Dexmedetomidine Infusion on Hemodynamic Stress Response, Sedation and Post-operative Analgesic Requirement in Patients Undergoing Laparoscopic Cholecystectomy. Indian J Anesth Analg. 2019;6(5 Part-1):1559-1568.

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Abstract

Dexmedetomidine is a selective α2 agonist with sedative, analgesic and sympatholytic properties and hence, it can be used as an anesthetic adjuvant. Aims: We aimed primarily to evaluate the effects of low dose Dexmedetomidine infusion on hemodynamic response to critical incidences such as laryngoscopy, endotracheal intubation, creation of pneumoperitoneum and extubation in patients undergoing laparoscopic cholecystectomy. The secondary aims were to observe the effects on sedation levels, post-operative analgesia requirements and occurrence of adverse effects. Methods: Ninety patients of American Society of Anesthesiologists [ASA] physical grades I and II undergoing laparoscopic cholecystectomy were randomly allocated into three groups of 30 patients each as follows: Group NS: [Saline group; n = 30] – Received 0.9% normal saline infusion; Group DEX: 0.2-Patients received Dexmedetomidine infusion 0.2 mcg/kg/hr; Group DEX: 0.4-Patients received Dexmedetomidine infusion 0.4 mcg/kg/hr. Infusions were started 15 min before induction and continued till end of surgery. Parameters noted were pulse rate, mean arterial pressure, post-operative sedation and analgesia requirements. SPSS 15.0 version software was used for statistical analysis and Continuous data were analyzed by ANOVA test. Results: In Group NS, significant hemodynamic stress response was seen following laryngoscopy, tracheal intubation, creation of pneumoperitoneum and extubation. In Dexmedetomidine groups, the hemodynamic response was significantly attenuated. The results, however, were statistically better in Dex 0.4 group compared with Dex 0.2 group. Post-operative 24 hour analgesic requirements were much less in Dexmedetomidine groups. No significant side effects were noted. Conclusion: Low dose Dexmedetomidine infusion in the dose of 0.4 mcg/kg/h effectively attenuates hemodynamic stress response during laparoscopic surgery with reduction in post-operative analgesic requirements.

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Sarada Roja Madhuri, Killi Bhagyalakshmi, Malapolu Neeraja. Effects of Dexmedetomidine Infusion on Hemodynamic Stress Response, Sedation and Post-operative Analgesic Requirement in Patients Undergoing Laparoscopic Cholecystectomy. Indian J Anesth Analg. 2019;6(5 Part-1):1559-1568.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6519.11

Keywords

Dexmedetomidine; Hemodynamic stress response; Laparoscopic cholecystectomy.

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