AbstractBackground and Aims: Hyperglycemia and hemodynamic perturbations are the main features of neuroendocrine stress response to surgical trauma and anesthesia. We conducted a study to evaluate and compare dexmedetomidine and fentanyl as anesthetic adjuvants in attenuating neuroendocrine stress response by measuring the changes in the perioperative serial blood glucose levels and monitoring hemodynamic variations during laparoscopic cholecystectomy.
Methodology: Sixty healthy adult patients scheduled for elective laparoscopic cholecystectomy were randomly assigned into two groups (Group D and Group F) of 30 each. Group D patients received dexmedetomidine 1µg/kg/15min whereas group F patients received fentanyl 2µg/kg/15min as loading dose and then the patients were infused with 0.20.7 µg/kg/ h of the respective drug till the end of surgery. Blood glucose levels were measured preoperatively before administration of premedication (baseline) (T0), at 30 minutes after beginning of surgery (T1) and 5 minutes postextubation (T2). Heart rate (HR), oxygen saturation (SpO2), systolic (SBP), diastolic (DBP) and mean arterial pressures (MAP) were assessed at specific time intervals.
Result: Blood glucose concentration increased in both groups, though group F showed a more obvious increment than group D. T1 and T2 mean values in group D (115.57 and 118.80mg/dl respectively) were significantly (p=0.020 and p< 0.001 respectively) lower than that in group F (122.37 and 128.90mg/dl respectively). HR, SBP, DBP and MAP were also significantly lower in group D than group F at various time points.
Conclusion: Dexmedetomidine is a better anesthetic adjuvant than fentanyl in attenuating the neuroendocrine stress response during laparoscopic cholecystectomy.
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