Background and Aim:Dexmedetomidine is a α2 agonist with sedative, sympatholytic and analgesic properties and hence, it can be a very useful adjuvant in anaesthesia as stress response buster, sedative and analgesic. We aimed primarily to evaluate the effects of low dose dexmedetomidine infusion on haemodynamic response to critical incidences such as laryngoscopy, endotracheal intubation, creation of pneumoperitoneum and extubation in patients undergoing laparoscopic cholecystectomy. The secondary aims were to observe the effects on extubation time, sedation levels, post-operative analgesia requirements and occurrence of adverse effects.Methods:Sixty patients of American Society of Anaesthesiologists(ASA) physical grades I and II undergoing laparoscopic cholecystectomy were randomly allocated into three groups of 20 patients each. Group NS patients received normal saline, Group Dex 0.2 and Group Dex 0.4 patients received dexmedetomidine infusion at 0.2 mcg/kg/h and 0.4 mcg/kg/h respectively, starting 15 min before induction and continued till end of surgery. Parameters noted were pulse rate, mean arterial pressure, oxygen saturation, post-operative sedation and analgesia requirements. SPSS 15.0 version software was used for statistical analysis. ANOVA test for continuous variables, post-hoc test for intergroup comparison, and Chi-square test for discrete values were applied.Results:In Group NS significant haemodynamic stress response was seen following laryngoscopy, tracheal intubation, creation of pneumoperitoneum and extubation. In dexmedetomidine groups, the haemodynamic response was significantly attenuated. The results, however, were statistically better in Dex 0.4 group compared with Dex 0.2 group. Post-operative 24 hour analgesic requirements were much less in dexmedetomidine groups. No significant side effects were noted.Conclusion:Low dose dexmedetomidine infusion in the dose of 0.4 mcg/kg/h effectively attenuates haemodynamic stress response during laparoscopic surgery with reduction in post-operative analgesic requirements.

Background: Endotracheal intubation is of paramount importance in general anaesthesia requires relaxation of laryngeal musculature leading to total inactivity of vocal cords. Suxamethonium chloride, a depolarizing muscle relaxant due to its quick onset of action and excellent intubating conditions has remained a muscle relaxant of choice. Rocuronium was proved to be safe alternative to suxamethonium for endotracheal intubation. Aims & Objective: To find out the utility of Inj. Rocuronium Bromide a non-depolarizing muscle relaxant (NDMR) as an alternative to Suxamethonium chloride, a depolarizing muscle relaxant (DMR) for the purpose of intubation of trachea with emphasis on onset of time for muscle relaxation, duration of action, hemodynamic changes and complications if any. Materials and Methods: This is a randomized clinical study carried out at tertiary care center. 90 patients were randomly divided into three groups. Group S60 (n=30)-Inj. Suxamethonium 1.5 mg/kg IV given I.V, Group R60 (n=30)-Inj. Rocuronium 0.6 mg/kg IV given I.V and Group R90 (n=30)-Inj. Rocuronium 0.6 mg/kg IV given I.V. The intubating conditions were judged clinically at fixed time interval i.e. either at 60 seconds or 90 seconds as per the group of patient, after the injection of study drug with the help of four point scale. The observed results were compiled and analyzed statistically by using chi-square test for qualitative data and students "t" test for quantitative data, the analysing system being that of EPI INFO. Results: The mean age was 29.2 ± 12.60, 28.83 ± 8.50 & 30.1 ± 10.47 years, respectively in S60, R60 and R90 group. Intubating conditions were excellent (score 8-9) in all the 30 patients (100%) in Group S60, in 23 patients (76.66%) of Group R60 and in 28 patients (93.33%) of Group R90. The mean onset time in our study were 46.66±5.46 seconds in Group S60, 76.33 ± 10.33 seconds in Group R60 and 78.33 ± 9.4 in R90. The duration of action in our study was 5.93 ± 1.25 minutes in Group S60 compared to 29.83±5.49minutes in Group R60 and 27.83 ± 3.13 minutes in R90. Conclusion: Rocuronium can serve as a good alternative to Suxamethonium for tracheal intubation in conditions where Suxamethonium is contraindicated or where its use is hazardous.

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