Effects of dexmedetomidine on haemodynamics in patients undergoing laparoscopic cholecystectomy- A comparative study

Bhattacharjee, Dhurjoti Prosad; Nayek, Sushil Kumar; Dawn, Satrajit; Bandopadhyay, Gargi; Gupta, Krishna Kumar

doi:10.4103/0970-9185.75105

Cited by 36 publications

(16 citation statements)

References 9 publications

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“…It is essential to match these factors to determine any confounding factors that can arise and affect the hemodynamic factors. As noted from the above-mentioned data, our study is comparable concerning parameters such as age, gender, weight, and ASA grading, which was similar to studies conducted by other authors, such as Bhattacharjee et al 13 and Kumar et al The HR, SBP, DBP, and MAP were measured before premedication, after premedication, 1 min after intubation, 5 min after intubation, during incision, at the start of pneumoperitoneum, 15 min after pneumoperitoneum, 30 min after pneumoperitoneum, 60 min after pneumoperitoneum, 15 min after the release of pneumoperitoneum, immediately after surgery, 15 min postoperatively, 30 min postoperatively, 45 min postoperatively, and 60 min postoperatively. Fall in HR after premedication was observed in Group D and was continued to be on the lower side when compared to Group S, throughout pneumoperitoneum.…”

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

“…There were 19 and 17 patients with ASA grade I in Group D and Group S, respectively, and 11 and 13 patients with ASA grade II in Group D and Group S, respectively. In 2010, a similar study by Bhattacharjee et al 13 evaluated the effect of dexmedetomidine on hemodynamics in patients undergoing laparoscopic cholecystectomy, and nonsignificant differences were observed with regards to age, gender, and ASA grading, similar to our study. It is essential to match these factors to determine any confounding factors that can arise and affect the hemodynamic factors.…”

Section: Discussionsupporting

confidence: 86%

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Study of Hemodynamic Effects of Preoperative Single-Bolus Dexmedetomidine in Elective Laparoscopic Surgeries

Fasil

Saundattikar

Jawale

et al. 2022

Journal of Pharmacology and Pharmacotherapeutics

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Objective: To observe the hemodynamic effects of a single bolus dose of dexmedetomidine in patients undergoing elective laparoscopic surgeries. Methods: A total of 60 adult patients were randomized into two groups of 30 each. Group D patients were given 1 µg/kg dexmedetomidine in 50 mL of saline as a single-dose infusion over 10 min before induction. Group S patients were given a 50-mL 0.9% NS slow infusion over 10 min. Groups D and S patients were premedicated 10 min prior to surgery. Baseline vital and hemodynamic parameters were monitored during the perioperative period. Conclusion: Premedicating with a single bolus of 1 µg/kg IV dexmedetomidine has been proven safe and effective in maintaining perioperative hemodynamic stability, although few developed bradycardia and hypotension, which were managed without any adverse outcome. Furthermore, dexmedetomidine effectively reduced the incidence of shivering.

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Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 91%

Section: Discussionsupporting

confidence: 86%

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Study of Hemodynamic Effects of Preoperative Single-Bolus Dexmedetomidine in Elective Laparoscopic Surgeries

Fasil

Saundattikar

Jawale

et al. 2022

Journal of Pharmacology and Pharmacotherapeutics

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“…The dexmedetomidine bolus administered for tracheal intubation ranged from 1 µg/kg [ 4 , 17 , 19 , 21 , 22 ] to 0.01 µg/kg [ 15 ]. Five studies used a bolus dose > 0.7 µg/kg (dexmedetomidine group: 137 patients; placebo/no intervention group: 139 patients) [ 4 , 17 , 19 , 21 , 22 ], five studies used a dose between 0.7 µg/kg and 0.4 µg/kg (dexmedetomidine and placebo/no intervention groups: 177 patients each) [ 13 , 14 , 20 , 24 , 26 ], four studies used a dose < 0.4 µg/kg (dexmedetomidine and placebo/no intervention groups: 115 patients each) [ 15 , 16 , 18 , 23 ], and one study [ 25 ] used both medium and high bolus doses of dexmedetomidine (dexmedetomidine group: 90 patients; placebo/no intervention group: 30 patients). The characteristics of the included studies are available in Supplemental Data S2 .…”

Section: Resultsmentioning

confidence: 99%

“…Five studies used a dexmedetomidine dose ≥ 0.70 µg/kg [ 4 , 14 , 17 , 19 , 21 ], one study used a dose between 0.70 and 0.40 µg/kg [ 24 ], and three studies used a low dose regimen (< 0.40 µg/kg) [ 15 , 16 , 23 ], while one study [ 25 ] used all three regimens. There were no differences regarding the occurrence of intraoperative bradycardia when considering the three different dose regimens (P = 0.47, I 2 = 0% for subgroup differences).…”

Section: Resultsmentioning

confidence: 99%

Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis

Cassai¹,

Sella²,

Geraldini³

et al. 2022

Korean J Anesthesiol

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Background: Laparoscopic surgical procedures have various advantages over traditional open techniques, however, the artificial pneumoperitoneum is associated with severe bradycardia and also with cardiac arrest. Dexmedetomidine is an imidazole derivative that highly selectively binds to α2-receptors. It has sedative and analgesic properties, however it could cause hypotension and bradycardia. Our primary aim was to assess the association of dexmedetomidine use with intraoperative bradycardia during laparoscopic cholecystectomy. Methods:We performed a systematic review with meta-analysis and trial sequential analysis of the medical literature using the following PICOS: adult patients undergoing endotracheal intubation for laparoscopic cholecystectomy (P); intravenous dexmedetomidine before tracheal intubation (I); no intervention or any placebo administration (C); intraoperative bradycardia (primary outcome), intraoperative hypotension, SBP at intubation, MAP at intubation, HR at intubation, dose of anesthetic needed for induction of anesthesia, total anesthetics (both ipnotics and opioids) requirement throughout the operative procedure, percentage of patients requiring postoperative analgesics, PONV and postoperative shivering occurrence (O); randomized controlled trials (S).Results: Fifteen studies were included in the meta-analysis (980 patients). Patients receiving dexmedetomidine compared to patients not receiving it had a higher risk of developing intraoperative bradycardia )) and hypotension (RR 1.66 (0.92 -2.98)), however they need lower dose of intraoperative anesthetics and had a lower incidence of PONV. In the TSA for bradycardia, the cumulative z-score crossed the monitoring boundary for harm at the tenth trial.Conclusions: Patients undergoing laparoscopic cholecystectomy receiving dexmedetomidine at tracheal intubation are more likely to develop intraoperative bradycardia and hypotension.

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Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery

Duncan

Sankar

Beattie

et al. 2018

Cochrane Database of Systematic Reviews

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Our review concludes that prophylactic α-2 adrenergic agonists generally do not prevent perioperative death or major cardiac complications. For non-cardiac surgery, there is moderate-to-high quality evidence that these agents do not prevent death, myocardial infarction or stroke. Conversely, there is moderate quality evidence that these agents have important adverse effects, namely increased risks of hypotension and bradycardia. For cardiac surgery, there is moderate quality evidence that α-2 adrenergic agonists have no effect on the risk of mortality or myocardial infarction, and that they increase the risk of bradycardia. The quality of evidence was inadequate to draw conclusions regarding the effects of alpha-2 agonists on stroke or hypotension during cardiac surgery.

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Effects of dexmedetomidine on haemodynamics in patients undergoing laparoscopic cholecystectomy- A comparative study

Cited by 36 publications

References 9 publications

Study of Hemodynamic Effects of Preoperative Single-Bolus Dexmedetomidine in Elective Laparoscopic Surgeries

Study of Hemodynamic Effects of Preoperative Single-Bolus Dexmedetomidine in Elective Laparoscopic Surgeries

Preoperative dexmedetomidine and intraoperative bradycardia in laparoscopic cholecystectomy: a meta-analysis with trial sequential analysis

Alpha-2 adrenergic agonists for the prevention of cardiac complications among adults undergoing surgery

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