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Indian Journal of Anesthesia and Analgesia

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Study of Efficacy and Safety of Dextmedetomidine Vs Midazolam in Gynacological Laproscopic Surgery

Ganesh Kisanrao Nikam, Associate Professor, Department of Anaesthesiology, SRTR Government Medical College, Ambajogai, Maharashtra 431517, India. , Yogesh Magan Suryavanshi1 , Ganesh Kisanrao Nikam2

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Indian Journal of Anesthesia and Analgesia 5(3):p 364-371, March 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.2

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Abstract

Background: Laparoscopic surgeries under are associated with unique hemodynamic changes thus a basic need is felt among the anaesthesiologist fraternity for the desired availability of a drug that effectively suppresses all the hazardous responses to obnoxious stimuli with a maximum safety margin. Dexmedetomidine due to its distinct sedation, analgesia and sympatholytic properties can be used as an anaesthetic adjuvant in anaesthesia for Laparoscopic surgeries. Thus we undertook this double blind, prospective comparative study. Methods: Fifty women undergoing Laparoscopic gynaecological Surgeries divided randomly by a computer generated table into two groups of 25 each. D group - Dexmedetomidine loading dose 1µg/kg followed by maintenance infusion of Dexmedetomidine at 0.4µg/kg/hr M Group – Midazolam loading dose 0.03 mg/kg followed by maintenance infusion of saline. Both the group were given Fentanyl citrate 1ug/kg. We undertook this double blind, prospective comparative study to evaluate efficacy and safety and its effect on sedation, hemodynamic, anaesthesia and analgesia requirement and recovery characteristics. Results: Baseline Mean degree of sedation was same but after 5 min study drug it was 2 for group D compared to group M -1.32 and postoperative 1.16 for group D and 1.08 for group M. Mean heart rate was 73.84 for group D and 74.52 for group M. Mean blood pressure was 100.84 for group D and 102.56 for group M. Same trend observed at the time of induction, intubation, mean during pneumoperitonium and mean value in PACU. Mean dose of fentanyl required was less 65µg compared to 93.4µg in group M. Conclusion: This randomised, double blind study demonstrated that when compared to Midazolam Dexmedetomidine is more effective anaesthetic adjuvant that causes adequate sedation without respiratory depression, decreases requirement of anaesthetic and opioid, attenuate sympathoadrenal response, maintains stable haemodynamics perioperatively at the same time provide excellent recovery profile without any adverse events but continuous monitoring for hypotension and bradycardia is essential during first two hours of postoperative period if higher infusion rate are used.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5318.2

Keywords

Midazolam Dexmedetomidine; Anaesthesia; Laparoscopic Surgeries.

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