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Indian Journal of Anesthesia and Analgesia

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Effects of Dexmedetomidine on Intraoperative Hemodynamics and Opioid Requirement in Laparoscopic Cholecystectomy

Bhavna Kakkar* , Bhavna Kakkar* , Sabih Ahmad** , Pavan Gurha*** , Lalit Gupta**** , Anish Gupta*****

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Indian Journal of Anesthesia and Analgesia 4(2):p 191-196, April - June 2017. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.2

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Abstract

Introduction: Laparoscopic surgery poses a challenge to its successful anesthetic management due to its significant alteration of hemodynamics resulting from pneumoperitoneum. Dexmedetomidine although frequently used in laparoscopic surgeries produces sedation, analgesia and anxiolysis, alongwith decreasing heart rate and blood pressure. We intended this study to use a lower loading dose of 0.6 µg/kg and maintenance dose of 0.3 µg/kg/h dexmedetomidine so as to utilize its wonderful properties without causing the adverse effects of hypotension and bradycardia, which are common at its usual loading dose of 1 µg/kg and also to study its opioid sparing effect. Methodology: A double blinded randomised placebo controlled trial was conducted on sixty adult patients, ASA grade I or II of either sex, aged 18 to 60 years who underwent elective laparoscopic cholecystectomy. Patients were divided into two groups who received dexmedetomidine and normal saline and intraoperative hemody­namicswere studied at different time­points. Results: The two groups were comparable with respect to mean duration of surgery (46.67±4.35 vs 47.43±3.96), mean extubation time (6.77 ± 0.73 vs 7.00 ± 0.58), and response to oral commands (8.59 ± 0.7 vs 8.78 ± 0.72). Mean heart rate and blood pressure variations were significantly lower in dexmedetomidine group at all time­points. Fentanyl requirement and post­operative nausea/vomiting was also significantly less in dexmedetomidine group and none patient had any episode of bradycardia, hypotension or hypertension. Conclusion: Dexmedeto­midine 0.6 µg/kg followed by maintenance of 0.3 µg/kg/h provides perioperative hemodynamic stability, facilitates smooth emergence from anesthesia, has opioid sparing properties and reduces post op nausea and vomiting.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.4217.2

Keywords

Opioid; Dexmedetomidine; Hemodynamics; Laparoscopic Cholecystectomy.

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