Dexmedetomidine as an anesthetic adjuvant in laparoscopic surgery: An observational study using entropy monitoring

Abstract

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.

Multimodal versus Conventional Approach for Postoperative Pain Relief in Oral Cancer Patients

“…The HR was observed to be lowest in Group C and highest in Group A. The findings of the present study are similar to other studies [10][11][12].…”

Intranasal Dexmedetomidine in Termination of First Trimester Pregnancy of Suction Evacuation

“…Therefore we demonstrated that intranasal dexmedetomidine reduced the propofol requirement during termination of first trimester pregnancy of suction evacuation. Our result was also consistent with other previous studies that dexmedetomidine might reduce the anesthetic dosages [8,9,23]. Guan et al showed that the mean consumption of propofol for termination of first trimester pregnancy of suction evacuation was 3.56 ± 0.98 mg/kg for propofol and 2.11 ± 1.08 mg/kg for propofol combined with sulfentanil5.…”

“…Dexmedetomidine is a highly selective α 2 -adrenoceptor agonist with sedative, anxiolytic and analgesic effects [6]. Dexmedetomidine has been used as a sedative agent in intensive care unit and an anesthetic adjunct in surgery [7][8][9]. Recently, more and more studies propose it as a sedative agent in moderate sedation for clinical surgeries/procedures [10][11][12][13].…”

Intravenous dexmedetomidine 1µg/kg as premedication to attenuate hemodynamic response to laryngoscopy and endotracheal intubation in surgeries under general anesthesia

“…23,24,26 In study of Poonam Ghodki et al, they observed reduction in propofol dose by 62 %. 25 We did not observe any complication or side effects related to Dexmedetomidine infusion, laryngoscopy and intubation in present study.…”