Comparative Evaluation of Dexmedetomidine and Esmolol on Hemodynamic Responses During Laparoscopic Cholecystectomy
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 th...
Main Authors: | , , , , , |
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Format: | Article |
Language: | English |
Published: |
JCDR Research and Publications Private Limited
2015-03-01
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Series: | Journal of Clinical and Diagnostic Research |
Subjects: | |
Online Access: | https://jcdr.net/articles/PDF/5674/11607_CE(Ra1)_F(GH)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf |
Summary: | 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.
Results: In group D, there was no statistically significant increase
in HR and blood pressure after pneumoperitoneum at any time
intervals, whereas in Group E, there was a statistical significant
increase in MAP after pneumoperitoneum at 15, 45, and 60 min
only and HR during the whole pneumoperitoneum period. There
was a significant decrease in induction dose of propofol and
intraoperative fentanyl requirement in Group D and E, compared
to Group C (p<0.0001).
Conclusion: Dexmedetomidine is more effective than esmolol for
attenuating the hemodynamic response to pneumoperitoneum in
elective laparoscopic cholecystectomy. Dexmedetomidine and
esmolol also reduced requirements of anaesthetic agents. |
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ISSN: | 2249-782X 0973-709X |