Effects of dexmedetomidine on intraoperative hemodynamics and propofol requirement in patients undergoing laparoscopic cholecystectomy

Abstract

Background:Despite multiple benefits, laparoscopic surgery always poses anesthetic challenge due to significant alteration of hemodynamics. Various pharmacological agents have been used for the same with variable response. Dexmedetomidine, in addition to sympatholytic effect, diminishes intraoperative requirement of anesthetics including propofol. The present study was conducted to evaluate the effects of intravenous dexmedetomidine on intraoperative hemodynamics and propofol requirement using bispectral index (BIS) in laparoscopic cholecystectomy.Methods:Forty patients undergoing laparoscopic cholecystectomy were randomly allocated to receive either dexmedetomidine (Group A; n = 20) or normal saline (Group B; n = 20). In Group A, dexmedetomidine was loaded (1 μg/kg) before anesthesia induction and infused (0.6 μg/kg/h) during surgery. Anesthesia was induced with propofol, and maintenance infusion rate was adjusted to a BIS of 55–60 in both groups. Mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and at various time points from loading of drugs to just after tracheal extubation. All infusions were stopped with removal of scope from abdominal cavity. Recovery time (time from end of all infusions to BIS = 80) and extubation time (time from end of all infusions to extubation) were noted.Results:After intubation, MAP and HR values in Group A were significantly lower than Group B at various time points of study. To achieve similar BIS values, significantly low doses of propofol were required in Group A during induction and intraoperatively. Doses were reduced by 36% and 31%, respectively. Mean recovery time and mean extubation time in Group A were also significantly less.Conclusion:During propofol-based anesthesia for laparoscopic cholecystectomy, dexmedetomidine provides stable intraoperative hemodynamics and reduces propofol requirement for induction as well as maintenance, without compromising recovery profile.

A randomized control study on anesthetic effects of flurbiprofen axetil combined with propofol on patients with liver cancer receiving microwave ablation

“…Therefore, delirium, nausea, vomiting, and headache are all adverse reactions produced by traditional narcotics. 19 Herein, there were fewer adverse reactions after surgery in the study group, mainly because flurbiprofen axetil had no central effect and a strong sedative effect, which could significantly reduce the adverse reactions caused by propofol and after anesthesia.…”

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“…However, in a research done by Khare and his colleagues [32] on non-MO patients, a significant less recovery time besides extubation time were found in dexmedetomidine group. This could be related to some degree by the lesser propofol requirement with the use dexmedetomidine as an adjunct medication.…”

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“…P < 0.05 is significant. et al [23] found that recovery time was significantly less when dexmedetomidine was added to propofol infusion during laparoscopic cholecystectomy. Another study showed that recovery from anesthesia was faster when dexmedetomidine was used as adjunct during general anesthesia [24].…”