Dexmedetomidine improves the hemodynamic stability during perioperative period in laparoscopic cholecystectomy

Author: 
Suchit Khanduja., Neha Khanduja., Anil Ohri and Vivek Loomba

Introduction:The development of the highly specific α2-adrenoceptor agonist dexmedetomidine has created a new interest in the use of α2-adrenoceptor agonists to control stress response to various noxious stimuli, perioperative hemodynamic stability and to provide better sedation without postoperative respiratory depression.

Aim: To evaluate if dexmedetomidine improves the hemodynamic stability during laparoscopic cholecystectomy under general anesthesia.

Material and Methods: Thirty patients in each of control and dexmedetomidine groups were included in this study. Induction was done by 2 mg/kg thiopentone sodium supplemented with 25mg thiopentone sodium. Recording of various parameters was done every 15 min after creation of pneumoperitonium till the end of pneumoperitonium. A new approach, difference in maximum and minimum of pulse rate and mean arterial pressure of individual patient, was used to assess the hemodynamic stability.

Results: Infusion of dexmedetomidine did not affect the basal pulse and pulse rate at 30 minutes. However, BMap in the test group decreased significantly after 30 minutes. Dexmedetomidine significantly decreased Pulsemax-min, MAPmax-min. Though, the intubation increased the pulse and MAP of the patient with respect to Pulse30 ( PIP-Pulse30) and MAP30 ( PIMAP-MAP30), but dexmedetomidine treatment of the patients undergoing surgery significantly decreased the increase in pulse rate and mean arterial pressure.

Conclusion: Infusion of dexmedetomidine during laparoscopic cholecystectomy led to decreased variation in pulse and mean arterial pressure indicative of hemodynamic stability.

Page: 
415-418
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