Comparative Evaluation of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy

Abstract

Background: The advent of laparoscopic surgery has benefited the patient and surgeon; however creation of pneumoperitoneum for same has bearings during the perioperative period. These effects of pneumoperitoneum are associated with significant haemodynamic changes, increasing the morbidity of the patient. Aim:The present study compared the efficacy of dexmedetomidine and esmolol on hemodynamic responses during laparoscopic cholecystectomy Materials and Methods: A total of 90 patients aged 20-60 y, American Society of Anaesthesiologists (ASA) physical status I or II, of either sex, planned for laparoscopic cholecystectomy were included. The patients were randomly divided into three groups of 30 each. Group D received dexmedetomidine loading dose 1 mcg/kg over a period of 15 min and maintenance 0.5 mcg/kg/h throughout the pneumoperitoneum. Group E received esmolol loading dose 1 mg/kg over a period of 5 min and maintenance 0.5 mg/kg/h throughout the pneumoperitoneum. Group C received same volume of normal saline.Measurements: Heart rate (HR), systolic blood pressure, diastolic blood pressure and mean arterial pressure (MAP) were recorded preoperative, after study drug, after induction, after intubation, after pneumoperitoneum at 15 min intervals, post pneumoperitoneum and postoperative period after 15 min. Propofol induction dose, intraoperative fentanyl requirement and sedation score were also recorded.

Comparative evaluation of different doses of intravenous dexmedetomidine during laparoscopic cholecystectomy under general anesthesia

“…[7,8] A study compared hemodynamic responses after dexmedetomidine and esmolol during laparoscopic cholecystectomy and found lower HR with dexmedetomidine. [9] Similar to our results, a previous study also reported that the intraoperative blood pressure values were significantly reduced in the dexmedetomidine 0.2, 0.4, and 0.8 mg groups compared with the control group. [6] The blood pressure in dexmedetomidine group was significantly lower after intubation, after reversal and post-operative recovery as compared to placebo group in another study.…”

“…There was no significant increase in blood pressure in dexmedetomidine group, compared to pre-operative levels during pneumoperitoneum, while it was a significant increase in control group during pneumoperitoneum period (P < 0.05). [9] Similarly, dexmedetomidine was superior to propofol in reducing HR and blood pressure during laparoscopic surgery. [8] A delay in recovery for first few hours post-extubation after using dexmedetomidine has been reported earlier.…”

Dexmedetomidine improves gastrointestinal motility after laparoscopic resection of colorectal cancer

“…[7,8] Earlier reports demonstrated that patients benefit a lot from perioperative application of Dex, such as reduced stress response during incubation and operation, and hemodynamic stability. [9,10] However, the effects of Dex on gastrointestinal function remain controversial. Some researchers demonstrated that Dex could protect intestine from injury caused by intestinal I/R and endotoxemia, [11,12] whereas others found that Dex would prolong the gastric emptying and gastrointestinal transit in the rat.…”

Effects of Preanesthetic Single Dose Intravenous Dexmedetomidine Versus Fentanyl on Hemodynamic Response to Endotracheal Intubation - A Clinical Comparative Study

“…3 Its usefulness in prevention of haemodynamic response to laryngoscopy and intubation has been the interest of present research. [4][5][6][7][8][9][10][11][12][13] Propofol is the most commonly used J Evid Based Med Healthc, pISSN-2349-2562, eISSN-2349-2570/ Vol. 2/Issue 59/Dec.…”