the Anesthetics in Patient’s Undergoing Laparoscopic Cholecystectomy under General Anesthesia

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the Anesthetics in Patient’s Undergoing Laparoscopic Cholecystectomy under General Anesthesia

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Introduction: Intravenous use of dexmedetomidine in the peri-operative period had been found to decrease serum catecholamine levels by 90%, to blunt the hemodynamic response to laryngoscopy, tracheal intubation, pneumoperitoneum and extubation, to provide sedation without respiratory depression and to decrease post-operative analgesic requirements. Aims: We aimed primarily to evaluate the effects of two different doses dexmedetomidine infusion on hemodynamic response to critical incidences such as laryngoscopy, endotracheal intubation, creation of pneumoperitoneum in patients undergoing laparoscopic cholecystectomy. The secondary aims were to study the dose sparing effect of dexmedetomidine on anesthetic drugs used. Methods: Hundred patients of American Society of Anesthesiologists (ASA) physical Grades I and II undergoing laparoscopic cholecystectomy were randomly allocated into two Groups of 50 patients each. Group A patients received dexmedetomidine infusion at 1 μg/kg and Group B patients received dexmedetomidine infusion at 0.6 μg/kg both over twenty minutes, starting 20 min before induction and thereafter, dexmedetomedine infusion continued at 0.2 µ/kg/hr in both the Groups till end of surgery. Parameters noted were pulse rate, mean arterial pressure, oxygen saturation, post-operative sedation and anesthetic drugs requirements. Chi-square test was used for qualitative data were applied. Results: Dexmedetomidine 1 μg/kg is more effective compared to Dexmedetomidine at 0.6 μ/kg in attenuating the tachycardia response to laryngoscopy, intubation and pneumoperitonem. Also, Dexmedetomidine at 1 μg/kg has a better dose sparing effect on anesthetic drugs used intra-operatively than Dexmedetomidine at 0.6 μg/kg. Both the Dexmedetomidine Groups provide light and arousable sedation post-operatively without respiratory depression. Conclusion: Dexmedetomidine infusion in the dose of 1 μg/kg effectively attenuates hemodynamic stress response during laparoscopic surgery with reduction in post-operative analgesic requirements.

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