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Comparison between the Effect of Dexmedetomidine and Preconditioning on Ischemic/Reperfusion Injury due to CO2 Pneumoperitoneum during Laparoscopic Cholecystectomy

Sameh T Abu Elela, Ezzat M Eltaher, Fatma M Khamis, Ghada A Kamhawy, Aiman A Al Touny, Nashwa R Hassan.

Abstract
Background: Pneumoperitoneum during laparoscopic surgeries elevates intra-abdominal pressure (IAP), inducing splanchnic ischemia, while deflation normalizes IAP and splanchnic blood flow leading to ischemia/reperfusion (I/R) injury and oxidant stress.
objective: Minimizing the injurious effect of laparoscopic pneumoperitoneum through comparing between the protective effect of intravenous (IV) dexmedetomidine infusion and preconditioning on I/R injury during laparoscopic cholecystectomy (LC) through measuring malondialdehyde (MDA) and total antioxidant status (TAS)
Methods: 45 adult patients planned for LC were randomly put into 3 equal groups; DEX group: patients received loading dose of dexmedetomidine infusion 1µg/kg IV over 10 minutes followed by maintenance dose 0.5 µg/kg/h till the end of surgery. PRE group: pneumoperitoneum was started for 5 minutes, then deflation for 5 minutes, insufflation was resumed again followed by surgery. Control group: patients were operated on by the classic technique. Venous samples were taken from patients preoperatively, 30 min after insufflation and 30 min after extubation to measure serum TAS and MDA.
Results: The use of dexmedetomidine resulted in significant increase(P

Key words: abdominal insufflation, Oxidant stress, Total antioxidant status and malondialdehyde



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