Sharma Preeti, Gombar Satinder, Ahuja Vanita, Jain Aditi, Dalal Usha
Department of Anaesthesia and Intensive Care, Government Medical College and Hospital, Chandigarh, India.
Department of Surgery, Government Medical College and Hospital, Chandigarh, India.
J Anaesthesiol Clin Pharmacol. 2017 Oct-Dec;33(4):496-502. doi: 10.4103/joacp.JOACP_144_16.
Sevoflurane is an excellent but expensive anesthetic agent for laparoscopic cholecystectomy. To decrease sevoflurane consumption during surgery adjuvants like dexmedetomidine may be used. Dexmedetomidine is a recently introduced drug which alleviates the stress response of surgery, produces sedation and analgesia. We aimed to evaluate sevoflurane sparing effect of dexmedetomidine in patients undergoing laparoscopic cholecystectomy under entropy-guided general anesthesia (GA).
In this prospective randomized control study, 100 American Society of Anesthesiologists physical status I-II adult surgical patients scheduled to undergo laparoscopic cholecystectomy were enrolled. Patients were randomly divided into two groups ( = 50). In dexmedetomidine group, patients received intravenous (IV) dexmedetomidine 0.5 μg/kg over 10 min before induction followed by 0.5 μg/kg/h infusion while in control group, patients received the same volume of normal saline.
Sevoflurane consumption was 41% lower in dexmedetomidine group as compared to control group (7.1 [1.6] vs. 12.1 [1.9] ml, <0.001). A 40% reduction was observed in induction dose of propofol (83.0 [19.1] vs. 127.6 [24.8] mg, <0.001). Mean Riker sedation-agitation score, visual analog score for pain and Aldrete's score were significantly lower in dexmedetomidine group as compared to control group. None of the patients experienced any significant side effects.
A 41% reduction in sevoflurane consumption was observed in patients receiving IV dexmedetomidine as an adjuvant in patients undergoing laparoscopic cholecystectomy under GA.
七氟醚是用于腹腔镜胆囊切除术的一种优质但昂贵的麻醉剂。为减少手术期间七氟醚的用量，可使用右美托咪定等辅助药物。右美托咪定是一种新近应用的药物，可减轻手术应激反应，产生镇静和镇痛作用。我们旨在评估熵指数引导下全身麻醉（GA）行腹腔镜胆囊切除术患者中右美托咪定对七氟醚的节约效应。
在这项前瞻性随机对照研究中，纳入了100例美国麻醉医师协会身体状况为I-II级、计划行腹腔镜胆囊切除术的成年外科患者。患者被随机分为两组（每组n = 50）。右美托咪定组患者在诱导前10分钟静脉注射（IV）右美托咪定0.5μg/kg，随后以0.5μg/kg/h的速度输注，而对照组患者输注相同体积的生理盐水。
与对照组相比，右美托咪定组七氟醚用量降低了41%（7.1 [1.6] vs. 12.1 [1.9] ml，P<0.001）。丙泊酚诱导剂量降低了40%（83.0 [19.1] vs. 127.6 [24.8] mg，P<0.001）。与对照组相比，右美托咪定组的平均Riker镇静-躁动评分、视觉模拟疼痛评分和Aldrete评分显著更低。所有患者均未出现任何明显的副作用。
在GA下行腹腔镜胆囊切除术的患者中，接受IV右美托咪定作为辅助药物的患者七氟醚用量降低了41%。
