Abstract
BACKGROUND: Dexmedetomidine, alpha 2 agonist, with its anxiolytic, sympatholytic and sedative property can be good adjuvant in anesthesia by modifying stress response to various stimuli during laparoscopic cholecystectomy including laryngoscopy, intubation, pneumoperitoneum, and extubation. We aimed to evaluate low dose dexmedetomidine for reducing hemodynamic perturbations to stressful events with secondary aim of evaluating propofol dose reduction and postoperative analgesia. METHODS: Sixty patients of American Society of Anesthesiologists Physical Status (ASA PS) Classes I and II were randomized to two groups of 30 each to receive dexmedetomidine infusion (0.5 mcg.kg(-1).h(-1)) starting 15 min before induction (Group A) and normal saline (Group B). Patient induced and maintained with propofol infusion to keep BIS value 55-60 in both groups and heart rate (HR) and mean arterial pressure (MAP) were recorded. We stopped infusions at surgical closure. VAS score recorded till 24 h of surgery. Total propofol required in both groups were recorded. Data were statistically analyzed using the SPSS software version 15.0. RESULTS: MAP and HR remain elevated following intubation in Group B and remain so throughout procedure and during all stressful events including CO(2) insufflation and tracheal extubation and were statistically significant. Significantly lower doses (almost 30%) of Propofol required in Group A to achieve similar BIS values compared to Group B. Visual Analog Scale score remained on the lower side in Group A for 24 h than Group B. CONCLUSION: Low dose dexmedetomidine (0.5 mcg.kg(-1).h(-1)) can effectively maintain hemodynamics during stressful events, reduces propofol requirement and improves postoperative analgesia in patients undergoing laparoscopic cholecystectomy.