Background:Dexmedetomidine, an α2 agonist, when used as an adjuvant in general anesthesia attenuates stress response to various noxious stimuli, maintains perioperative hemodynamic stability and provides sedation without adversely affecting recovery in postoperative period.Materials and Methods:Sixty patients were randomly divided into two groups of 30 each. In Group A, dexmedetomidine was given intravenously as loading dose of 1 μg/kg over 10 min, and normal saline was given in Group B patients. After induction with propofol, in Group A, dexmedetomidine was given as infusion at a dose of 0.2–0.8 μg/kg/h. Sevoflurane was used as inhalation agent in both groups. Perioperative monitoring parameters were recorded. Postoperative sedation and recovery were assessed.Statistical Analysis Used:Demographic data were analyzed using Pearson's Chi-square test. Changes in the heart rate (HR), systolic blood pressure (BP) and diastolic BP were analyzed using unpaired t-test and Mann–Whitney rank sum test was used to calculate “P” value wherever (Shapiro–Wilk)/normality test gave ambiguous results.Results:Dexmedetomidine significantly attenuates stress response at intubation with lesser increase in HR (86.00 ± 5.16 vs. 102.97 ± 7.07/min.), mean BP (95.78 ± 5.35 vs. 110.18 ± 5.35) as compared to the control group (P < 0.05). After pneumoperitoneum, HR was 85.07 ± 6.23 versus 107.10 ± 4.98, mean BP was 98.98 ± 10.16 versus 118.54 ± 6.27 (P < 0.05). Thus maintains intraoperative hemodynamic stability. Postoperatively, the test group showed no statistically significant difference in the extubation time (7.00 ± 0.58 vs. 6.74 ± 0.73) and response to oral commands (8.78 ± 0.72 vs. 8.66 ± 0.73) (P > 0.05).Conclusion:Dexmedetomidine attenuates various stress responses during surgery and maintains the hemodynamic stability when used as an adjuvant in general anesthesia and dexmedetomidine does not delay recovery.
Background and Aims:A popular method of providing anesthesia for laryngeal mask airway (LMA) insertion is with the use of propofol. However, bolus propofol has been associated with adverse effects such as hypotension, apnea and pain on injection. Hence, time is needed to search an alternative. We aimed to compare the induction characteristics, ease of LMA insertion, hemodynamic changes and complications with inhalation of 8% sevoflurane vital capacity breath and propofol.Material and Methods:A prospective randomized study of 60 American Society of Anesthesiologists' Grade I and II patients was conducted and distributed among two groups with 30 each undergoing gynecological procedures under general anesthesia. Group P received the injection propofol and Group S received sevoflurane. At the end point of induction, the LMA insertion was attempted. Scoring systems were used to grade the conditions for insertion of the LMA. Induction, LMA insertion characteristics, hemodynamic changes, complications were assessed. Data were recorded and analyzed. Comparison among the study groups was done with unpaired t-test, Mann–Whitney test and Chi-square test.Results:Sevoflurane took a longer time for induction and for LMA insertion than propofol. There was no statistically significant difference between the two groups, with respect to LMA insertion characteristics, heart rate, mean arterial pressure. It is concluded that sevoflurane is associated with good hemodynamic stability and may prove useful incases where propofol is to be avoided. However, the ease of insertion provided with propofol is better.
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