Effect of Dexmedetomidine Versus Fentanyl on Haemodynamic Response to Patients Undergoing Elective Laparoscopic Surgery: A Double Blinded Randomized Controlled Study
Journal Title: Journal of Clinical and Diagnostic Research - Year 2017, Vol 11, Issue 4
Abstract
Introduction: Dexmedetomidine, an a2 agonist, can be used as an adjuvant in general anaesthesia as it attenuates the stress response to various noxious stimuli and helps in maintaining the perioperative haemodynamic stability along with sedation and not causing any significant respiratory depression in the postoperative period. Aim: To study the difference in haemodynamic responses of dexmedetomidine and fentanyl in patients undergoing laparoscopic surgery. Materials and Methods: Sixty patients were divided into two groups of 30 each randomly. In Group F, fentanyl 0.5 μg/kg as loading dose over 10 minutes prior to induction followed by 0.2-0.7 μg/kg/hr as maintenance dose and in Group D, Dexmedetomidine 0.5 μg/kg as loading dose over 10 minutes prior to induction followed by 0.2 μg/kg/hr-0.7 μg/kg/hr as maintenance dose till surgery was over. Haemodynamic variables and Visual Analogue Scale (VAS) scores were recorded continuously. Postoperative sedation and recovery were assessed by modified Ramsay sedation score. Results: Systolic Blood Pressure (SBP) fell by 9% in Group-D as compared to no fall in Group F during intubation. After intubation, 9% increase is seen in Group D v/s 19% in Group F. During the period of pneumoperitoneum upto 5 minutes post extubation, the SBP in Group D was significantly lower as compared to Group F rest duration, the difference was not significant between both groups. Heart Rate (HR) remained stable throughout the study except at laryngoscopy when it rose. Heart rate was similar in both groups at intubation, decreased by 3.51% in Group D as compare to 11.11% rise in Group F. Post intubate on, heart rate fell by 2% in Group D vs 15% rise in Group F. Diastolic Blood Pressure (DBP) remained higher than baseline than throughout the study. After intubation, 3% higher in Group D where as 15% in Group F increase was seen. In intraoperative period the difference between both groups was not significant. There was significant difference between two groups at 10 minutes, 45 minutes of pneumoperitoneum. End Tidal CO2 (ETCO2 ) was similar in both groups. Conclusion: Dexmedetomidine is better drug as compared to fentanyl for maintaining the haemodynamic response during intubation and intraoperative period.
Authors and Affiliations
Lovina Neil, Ashok Patel
Accessory Grooves on the Diaphragmatic Surface of the Liver: A Cadaveric Study
Introduction: Usually liver does not possess any grooves on its diaphragmatic surface, but there are reports on the presence of grooves on this surface. Aim: The present study was conducted to study the gross features of...
Sex Determination from Talus among Gujarati Population of Anand Region by Discriminant Function Analysis
ABSTRACT Introduction: The three most vital determinations that must be made when dealing with skeletal remains are sex, age and race. Many skeletal features vary by gender, thus determination of sex is prerequisite for...
Newer v/s Classical Anthropometric Indices as a Screening Tool for Dyslipidemia in Healthy Young Adults
Introduction: The association of obesity with higher rates of dyslipidemia and cardiovascular diseases has been well documented. The most commonly used classical anthropometric indices do not provide an accurate distinct...
Variations in the Branching Pattern of the Radial Nerve Branches to Triceps Brachii Muscle
ABSTRACT Introduction: The axillary nerve arises from the posterior cord of the brachial plexus and supplies the deltoid and teres minor muscles. Axillary nerve injuries lead to abduction and external rotation weakness....
Correspondence: Application of CAD-CAM for Fabrication of Metal-free Band and Loop Space Maintainer
Letter to Editor