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Indian Journal of Anesthesia and Analgesia

Volume  7, Issue 2, Mar-Apr 2020, Pages 531-539
 

Original Article

Use of Surgical Plethysmographic Index to Assess the Effect of Dexmedetomidine on Hemodynamic Response to Intubation and Surgical Stress

Reena Nayar, Laviena Mallela, Vikram MS

1Professor, 2Post Graduate, 3Associate Professor, Department of Anesthesia and Intensive Care, St Johns Medical College Hospital, Koramangala, Bengaluru, Karnataka 560034, India.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.7220.14

Abstract

 

Aims: To study the use of surgical plethysmographic index in assessing the effects of dexmedetomidine in attenuating the hemodynamic stress response. Materials and Methods: A two group comparative study was
done on 60 patients of ASA I and II patients undergoing elective laproscopic cholecystectomy under general anesthesia in a tertiary referral hospital setting. Group F received 100 ml of normal saline while Group D received 0.5 g/kg of dexmedetomidine in 100 ml normal saline. Results: We found that rise in Heart Rate, Systolic and Diastolic BP and Mean Arterial Pressure was significantly attenuated in the dexmedetomidine group. The Surgical plethysmographic index (SPI) was also reduced. The SPI changed earlier than heart rate
and blood pressure in response to stimulation. Opioid and propofol need was also significantly reduced. Endocrine stress response was also attenuated as noted by the lower readings of blood sugar during the
surgery in the dexmedtomidine group. Conclusion: Surgical Plethysmographic Index is an effective indicator of analgesic depth. Dexmedetomidine attenuates the hemodynamic and neuroendocrine stress response to intubation and surgery and has opioid and anesthetic sparing effects.


Keywords : Surgical plethysmography index; Dexmedetomidine; Heart rate; Mean arterial pressure; Endocrine stress response.
Corresponding Author : Reena Nayar