Effect of Dexmedetomidine Versus Fentanyl on Haemodynamic Response to Patients Undergoing Elective Laparoscopic Surgery: A Double Blinded Randomized Controlled Study

Neil, Lovina; Patel, Ashok

doi:10.7860/jcdr/2017/24152.9563

Cited by 7 publications

(6 citation statements)

References 15 publications

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“…In our study, one patient receiving dexmedetomidine had irregular R-R interval intraoperatively which reverted back spontaneously. However, Vaswani et al 19 and Neil et al, 23 reported no such ECG abnormality with dexmedetomidine.…”

Section: Discussionmentioning

confidence: 97%

“…Our findings were similar to Jo et al who observed similar incidence of PONV, sedation scores and shivering with dexmedetomine and normal saline. 22 Vaswani et al, 19 and Neil et al 23 observed decreased incidence of hypertension, and tachycardia, increase in incidence of bradycardia and no respiratory depression with dexmedetomidine as compared to fentanyl. In our study, one patient receiving dexmedetomidine had irregular R-R interval intraoperatively which reverted back spontaneously.…”

Section: Discussionmentioning

confidence: 97%

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Nalbuphine versus dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation: A randomised double blind comparative study

Rathore¹,

Chaudhary²,

Kumar³

et al. 2021

IJCA

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Laryngoscopy and intubation are noxious stimuli which result in marked sympathetic response. However, literature search did not reveal any study comparing nalbuphine and dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation. After Institutional Ethical Committee approval and written informed consent, 80 ASA I and II patients were randomised in two groups of 40 each. Group N received 0.2 mg/kg of nalbuphine; group D received 1 µg/kg dexmedetomidine over a period of 10 min. Anaesthesia was induced as per standard general anaesthesia practice. Haemodynamic parameters [Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), & Mean Arterial Pressure (MAP)] were recorded at baseline, 0, 1, 3, 5, 10, and 15 min following intubation. Patients were also observed for any side effects of the study drugs.There was a significant decrease (p<0.001) in mean HR in group D compared to group N, after administration of drug and 1 min after intubation. Both group N and group D showed no significant increase in mean HR at any time point compared to baseline values. There was no significant increase in mean SBP at any time interval in both the groups when compared to baseline. There was a significant increase (p<0.001) in mean DBP and MAP at the time of intubation in group N whereas no significant increase in mean DBP, and MAP was observed in group D at any time point. Dexmedetomidine was found to be more effective in attenuating haemodynamic response to laryngoscopy and intubation as compared to nalbuphine.

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Section: Discussionmentioning

confidence: 97%

Section: Discussionmentioning

confidence: 97%

Nalbuphine versus dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation: A randomised double blind comparative study

Rathore¹,

Chaudhary²,

Kumar³

et al. 2021

IJCA

View full text Add to dashboard Cite

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“…The principle of balanced analgesia described by Kehlet [1] cholecystectomies, patients receiving remifentanil were experiencing experienced more bradycardia than those in the dexmedetomidine Dex group [28]. However, some studies have chosen to study OFA with dexmedetomidine Dex with the objective of hemodynamic stability and controlled hypotension [29,30]. While some studies were negative [31], most studies reported a good hemodynamic stability with often bradycardia and hypotension with dexmedetomidine Dex (which were the objectives in these studies) [32,33].…”

Section: Why Reducing or Avoiding Opioids Perioperatively?mentioning

confidence: 99%

Opioid-free anesthesia

Beloeil

2019

Best Practice & Research Clinical Anaesthesiology

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Opioid Free Anesthesia (OFA) is emerging as a new stimulating research perspective. The rationale to propose OFA is based on the aim to avoid the negative impact of intraoperative opioid on patient's postoperative outcomes and also on the physiology of pathways involved in intraoperative nociception. It is based on the concept of multimodal anesthesia. OFA has been shown to be feasible but the literature is still scarce on the clinically meaningful benefits for patients as well as on the side effects and / or complications that might be associated with it. This review focused first on the physiology of nociception, the reasons for using or not opioids during anesthesia, and then on the literature reporting evidence-based proofs of benefits / risks associated with OFA.

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“…Dexmedetomidine is a highly selective α 2 adrenoceptor agonist used as an adjuvant analgesic in the perioperative period [ 10 ]. This drug improves hemodynamic stability and reduces the stress induced by intubation because of its central sympatholytic action [ 11 ]. Furthermore, dexmedetomidine decreases the need for opioids and anesthetics, providing additional benefits for obese patients [ 12 ].…”

Section: Introductionmentioning

confidence: 99%

Perioperative use of ketamine infusion versus dexmedetomidine infusion for analgesia in obese patients undergoing bariatric surgery: a double-blinded three-armed randomized controlled trial

et al. 2023

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Background Bariatric surgery depends on the development of novel anesthetic techniques to reduce the incidence of complications and improve postoperative outcomes. Ketamine and dexmedetomidine have been used for perioperative analgesia and we hypothesized that they would decrease postoperative morphine requirements. The objective of this trial is to study whether choice of ketamine or dexmedetomidine infusion would affect postoperative total morphine consumption. Methods Ninety patients were equally randomized into three groups. The ketamine group received a bolus dose (0.3 mg/kg) of ketamine over 10 min, followed by an infusion of the same drug (0.3 mg/kg/h). The dexmedetomidine group received a bolus dose (0.5 mcg/kg) of dexmedetomidine over 10 min, followed by an infusion of this drug (0.5 mg/kg/h). The control group received a saline infusion. All infusions were given till 10 min before the end of surgeries. Intraoperative fentanyl was given when patient developed hypertension and tachycardia despite adequate anesthesia and muscle relaxation. Postoperative pain was managed by a rescue dose of 4 mg of IV morphine, with a minimum interval of 6 h between morphine doses if the numerical rating scale (NRS) score was ≥ 4. The primary outcome was the total morphine dose, and the secondary outcomes were intraoperative fentanyl requirement, time to extubation, postoperative nausea and vomiting (PONV), NRS scores, and modified observer’s agitation/sedation scale (MOASS) scores. Results Compared with ketamine, dexmedetomidine decreased the need for fentanyl intraoperatively (160 ± 42 µg), shortened the time to extubation (3 ± 1 min), and improved MOASS and PONV scores. In turn, ketamine decreased postoperative NRS scores and the need for morphine (3 ± 3 mg). Conclusions Dexmedetomidine treatment was associated with lower fentanyl doses, a shorter time to extubation, and better MOASS and PONV scores. Ketamine treatment was associated with significantly lower NRS scores and morphine doses. These results indicated that dexmedetomidine effectively decreased intraoperative fentanyl requirement and the time to extubation, while ketamine decreased the need for morphine. Trial registration This trail was registered on the clinicaltrials.gov registry (NCT04576975) on October 6, 2020.

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Effect of Dexmedetomidine Versus Fentanyl on Haemodynamic Response to Patients Undergoing Elective Laparoscopic Surgery: A Double Blinded Randomized Controlled Study

Cited by 7 publications

References 15 publications

Nalbuphine versus dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation: A randomised double blind comparative study

Nalbuphine versus dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and intubation: A randomised double blind comparative study

Opioid-free anesthesia

Perioperative use of ketamine infusion versus dexmedetomidine infusion for analgesia in obese patients undergoing bariatric surgery: a double-blinded three-armed randomized controlled trial

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