Background: Laparoscopy induces hemodynamic changes that lead to increased systemic vascular resistance, mean arterial pressure, heart rate, reduction in stroke volume, and cardiac output. Dexmedetomidine is a highly selective, potent, and specific alpha-2 agonist. It attenuates the hemodynamic changes associated with tracheal intubation, reduces plasma catecholamine concentration during anesthesia, and decreases perioperative requirements of inhaled anesthetics.
Objectives: This study attempts to compare the effects of two different doses of dexmedetomidine in maintaining perioperative hemodynamic parameters during laparoscopic cholecystectomy.
Materials and Methods: A total of 90 patients were randomly allocated to three groups, Group A (placebo), Group B (dexmedetomidine 0.5 μg/kg body weight), and Group C (dexmedetomidine 1 μg/kg body weight) of 30 patients each, undergoing elective laparoscopic cholecystectomy, under general anesthesia. The patients received preloaded study drug, 15 min before induction. The hemodynamic parameters were recorded before premedication, before induction, 1 min after intubation, 5 min after intubation before insufflation of CO2, after insufflation of CO2 at 1, 5, 10, 20, 30, 45, and 60 min, after release of CO2, at 1 and 10 min after extubation.
Results: The three groups were comparable for age, sex, weight as well as duration of surgery. Both doses maintained hemodynamic
stability during laparoscopic cholecystectomy. However, lesser sedation was seen in the Group B as compared to Group C.
Conclusion: Both doses of dexmedetomidine at doses were superior to placebo in terms of hamodynamic stability. Lesser sedation was seen with the 0.5 μg/kg body weight compared to dexmedetomidine 1 μg/kg body weight.
Key words: Dexmedetomidine; Pneumoperitoneum; Hemodynamic; Cholecystectomy
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