Laparoscopic surgeries involves creation of pneumo-peritoneum with insufflation of gas usually CO2 thereby increasing intra-abdominal pressure. The Intra-abdominal pressure above 10 mmHg causes adverse hemodynamic changes. Various agents have been used to attenuate these adverse effects. Dexmedetomidine alpha-2 agonist has sedative, sympatholytic, analgesic and anxiolytic properties and used in laparoscopic cholecystectomies for attenuation of adverse hemodynamic changes and to maintain hemodynamic stability.
60 patients of ASA 1-2 undergoing elective laparoscopic cholecystectomy were randomly allotted to two groups. Each group consists of 30 patients. Group 1 patients received dexmedetomidine infusion @0.2 microgram/kg/hour and group 2 patients received normal saline @0.2 microgram/kg/hour after intubation. The medication was stopped at the end of peritoneal deflation. Intraoperative hemodynamic stability was assessed by monitoring heart rate and Mean arterial pressure.
In Dexmedetomidine group, the haemodynamic response was significantly attenuated.
Dexmedetomidine infusion in the dose of 0.2 µg/kg/hour effectively attenuates haemodynamic stress response to pneumo-peritoneum during laparoscopic surgery.