Sundari Bose1, Kavin Kumar2, Siva Shanmugam3, Balaji Kumaresan4
BACKGROUND
The major concern of laparoscopic surgery is intra-operative hypercapnia induced
stress response such as increase in heart rate (HR), increase in blood pressure
(BP), increased stress hormones. The major concern of anaesthetist is to reduce
stress response perioperatively. Drugs like clonidine, dexmedetomidine,
nitroglycerine and esmolol are used to control the hemodynamic response
associated with pneumoperitoneum in laparoscopic surgeries. Dexmedetomidine
has been found to have hemodynamic stability with good analgesic effect.
Dexmedetomidine is a highly selective α2 agonist with sedative, analgesic and
sympatholytic properties. Here in this prospective randomized controlled study, we
evaluate the effects of intramuscular dexmedetomidine as a premedication in
laparoscopic cholecystectomy.
METHODS
This is a randomized controlled study. Forty patients aged 20 to 50 years, both
sexes, with American society of anaesthesiology (ASA) grade I & II planned for
elective laparoscopic cholecystectomy were randomly assigned into two groups,
Group DS : (N - 20) Received 2 mcg/kg of dexmedetomidine with normal saline
(total 2 ml) Group CS : (N - 20) Received 2 ml of normal saline as intramuscular
injection in the deltoid region 60 minutes before induction. We compared the
hemodynamic parameters like pulse rate, mean arterial pressure (MAP) in
baseline, preinduction, during intubation, before and after carbon dioxide
insufflation, post extubation, visual analog score (VAS) and the analgesic
requirements in both groups.
RESULTS
Compared to control group, intramuscular dexmedetomidine group had
statistically significant reduction in pulse rate, mean arterial pressure
perioperatively during intubation, before and after carbon dioxide insufflation,
during surgery and post extubation (P < 0.001) and also found to decrease the
analgesic requirement post operatively.
CONCLUSIONS
2 mcg/kg intramuscular dexmedetomidine premedication produces better
hemodynamic stability, reduced perioperative analgesic requirement and hence
could be a better alternative to other premedicant agents.
