Background:Dexmedetomidine is a highly selective α2 agonist with properties of sedation, analgesia and anxiolysis, making it an ideal anesthetic adjuvant. Using an anesthetic adjuvant that decreases requirement of anesthetics and analgesics may predispose the patient to awareness. We monitored the depth of anesthesia (DOA) using entropy to avoid unwanted awareness under anesthesia.Materials and Methods:30 patients, American Society of Anesthesiologists grade I and II, aged between 18 to 50 years of either gender undergoing laparoscopic surgeries under general anesthesia were studied. Loading dose infusion of dexmedetomidine was started 1 mcg/kg for 15 minutes and patients were premedicated. Routine induction with propofol and fentanyl was carried out, and maintenance infusion of dexmedetomidine 0.2 mcg/kg/hr was given. Patients were monitored with standard monitoring, and in addition, the DOA was monitored with entropy.Results:A 62.5% reduction (0.75 mg/kg) in the induction dose of propofol was observed, with a 30% less end-tidal concentration of isoflurane requirement for maintenance of anesthesia, while maintaining the adequate DOA.Conclusion:Dexmedetomidine is an effective anesthetic adjuvant that can be safely used in laparoscopy without the fear of awareness under anesthesia.

Sixty ASA grade I/II patients scheduled for elective short laparoscopic procedures under spinal anaesthesia were divided into two groups of 30 each. The first group (group C) received 3.5 ml of hyperbaric bupivacaine with 30 mcg of clonidine. The second group (group B) received plain bupivacaine 3.5 ml. Till date, the limiting factor for use of spinal anaesthesia for laparoscopy was patient’s discomfort due to shoulder tip pain. From our study it can be concluded that bupivacaine along with clonidine in low doses provides good sedation and analgesia in intraoperative and post-operative period and at the same time abolishes shoulder tip pain during laparoscopic procedures. In addition, no significant changes in haemodynamics occur with the low dose of clonidine used.

Background: Laparoscopic surgeries, including cholecystectomy are being performed on a large scale owing to the improved tissue healing and minimal hospital stay. However the haemodynamic response to pneumoperitoneum could pose a problem in these patients. The primary objective of this study was to evaluate the effectiveness of 1µg/kg intravenous clonidine in suppression of this hemodynamic response. The secondary objective was to assess the postoperative analgesia and sedation.Methods: 60 patients posted for laparoscopic cholecystectomy were divided into two groups. 30 patients received intravenous midazolam 0.03mg/kg and pentazocine 0.3mg/kg and the other 30 received intravenous clonidine 1µg/kg 15 minutes prior induction.Results: Intraoperative mean pulse rate was 90.82±4.81 beats per minute in control group. In clonidine group it was 74.76±9.88 beats per minute (p<0.05 significant). Similarly the mean systolic blood pressure was 137.87±4.89 and 125.79±6.44 respectively (p<0.05-significant). The duration of postoperative analgesia was 334.83±24.65 and 116.05±19.17 minutes respectively (p<0.05).Conclusions: Premedication with intravenous clonidine, has been found to be relatively safe as well as an effective method that provides stable haemodynamics and protection against stress response induced by pneumoperitoneum in patients undergoing laparoscopic cholecystectomy.

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Laparoscopic procedures are commonly performed and preferred over open laparotomies due to their unique advantages. Many laparotomies are now amenable to laparoscopic repair. One such surgery is laparoscopic fundoplication for hiatus hernia repair. The advent of this surgery has given rise to unique consequences which may turn out to be complications if not attended appropriately. AbsTRACTAccess this article online Quick Response Code: Website:www.e-jams.org

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