Dexmedetomidine versus Magnesium Sulfate as Adjunct during Anesthesia for Laparoscopic Colectomy

Abstract

Objectives. To compare dexmedetomidine versus magnesium during laparoscopic colectomy. Patients and Methods. 51 patients were randomly allocated into 3 groups: group C (control) received saline infusion, group D dexmedetomidine 1 g/kg and then 0.4 g/kg/hr, and group M MgSO4 2 g and then 15 g/kg/min. Intraoperative hemodynamics were measured before and 1 min after intubation (T1 and T2), before and 5 min after peritoneal insufflation (T3 and T4), before and 5 min after 30° Trendelenburg position (T5 and T6), 5 min after resuming flat position (T7), 5 min after peritoneal deflations (T8), after extubation (T9), and at time of admission to PACU (T10). Recovery time and degree of sedation were assessed. Results. HR and MAP were significantly higher in T2, T4, and T6 compared to T1, T3, and T5, respectively, in all groups with lower measurements in groups D and M compared to group C. Mean of collective measurements was significantly higher in group C. Recovery time and sedation score were significantly higher in groups D and M. Time to Aldrete score of ≥9 was significantly longer in groups D and M. Conclusion. Both drugs ameliorate the pressor responses during LC with a nonsignificant difference. This study is registered with PACTR201602001481308.

Comparison of effects and safety in providing controlled hypotension during surgery between dexmedetomidine and magnesium sulphate: A meta-analysis of randomized controlled trials

“…And then 4 studies were excluded by full-text review for they were performed in pediatric patients. At last, 10 RCTs were enrolled in further meta-analysis [14][15][16][17][18][19][20][21][22][23]. The identification procedure of these eligible articles is described in Fig 1. The enrolled studies were published from 2011 to 2018, and all of them were published in English.…”

“…A total of 663 patients were randomized to receive two drugs. In 10 included RCTs, 5 were researches about head and neck surgery [14][15][16][17][18], 3 were researches about spinal surgery [19][20][21], and the rest two trials were researches about pituitary adenoma surgery [22] and laparoscopic colorectal resection surgery [23]. All enrolled studies reported the hemodynamic parameters (MAP, HR), and 6 studies reported the evaluation of surgical field bleeding by using 6-point scale [14][15][16][17][18]22].…”

“…All enrolled studies reported the hemodynamic parameters (MAP, HR), and 6 studies reported the evaluation of surgical field bleeding by using 6-point scale [14][15][16][17][18]22]. Duration of surgery was reported in 8 studies [14][15][16][17][18][21][22][23], and the number of patients requiring opioid/analgesia administration was reported in 3 studies [14,16,18]. The recovery profile of patients was measured by the time till reaching Aldrete score �9 in 5 studies [14,[16][17][18]23].…”

“…Duration of surgery was reported in 8 studies [14][15][16][17][18][21][22][23], and the number of patients requiring opioid/analgesia administration was reported in 3 studies [14,16,18]. The recovery profile of patients was measured by the time till reaching Aldrete score �9 in 5 studies [14,[16][17][18]23]. The general characteristics and information of enrolled studies are described in Table 1.…”

Effects of Different Doses of Magnesium Sulfate on Pneumoperitoneum-related Hemodynamic Changes in Patients Undergoing Gastrointestinal Laparoscopy

“…During pneumoperitoneum for operative laparoscopy, impairment of hemodynamic status occurs mainly at the beginning of peritoneal insufflation [2]. It is well known that elevated intrapleural pressure significantly reduces the venous return and the circulating blood volume, which induces the elevated levels of vasopressin [1,2,10]. Adrenergic receptor blockers, calcium channel blockers, opioids, and vasodilators are routinely used to attenuate the pneumoperitoneum-related hemodynamic instability, but they are all accompanied with varying degrees of reduction in CO.…”