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Effect of dexmedetomidine on hemodynamic stability during laparoscopic surgeries: A randomized double-blind controlled trial

Vipin Singh, Rajiv Ratan Singh Yadav.

Abstract
Background: Certain drugs have been tried to increase hemodynamic stability during different phases of laparoscopic cholycystectomy. The pathophysiologic hemodynamic changes can be prevented by optimizing preload before pneumoperitoneum and by vasodilating agents.

Objective: A randomized double-blind controlled trial was planned with an objective to evaluate the effect of intraoperative dexmedetomidine with or without propofol in hemodynamic stability during laparoscopic surgery.

Material and Methods: A randomized double-blind controlled trial was conducted between November 2009 and August 2011. Patients were divided into two groups of 50 each according to table of computer generated random numbers. Group I patients received dexmedetomidine with propofol. Group II patients received propofol with normal saline (placebo) in the same volume and rate.

Results: The number of the patients with Ramsay sedation score of 2 was more in group II compared to group I. The sedation score subsequently was comparable in both the groups till next one hour. The pain as measured with numerical rating scale (median value) was lower in group I compared to group II at 1 h postoperatively and therefore the requirement of rescue fentanyl was less in group I compared to group II (p < 0.05).

Conclusion: It was concluded that the addition of dexmedetomidine with propofol provides better hemodynamic stability in normal patients undergoing laparoscopic surgeries and decreases the analgesic requirements preoperatively. Patients receiving dexmedetomidine in addition to the propofol are more sedated in early phase of postoperative period though became alert later.

Key words: Dexmedetomidine, hemodynamic stability, laparoscopic surgery


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