Effect of Two Different Doses of Dexmedetomidine on the Hemodynamics of "Hypertensive Patients" Undergoing Laparoscopic Cholecystectomy.

CONTEXT

In laparoscopic cholecystectomy, pneumoperitoneum results in tachycardia, hypertension, and increased myocardial oxygen demand. These changes are more pronounced in hypertensive patients. The intravenous administration of dexmedetomidine attenuates sympathoadrenal response and provides better hemodynamic stability intraoperatively.

AIMS

To evaluate the hemodynamic stabilizing and sedation properties of two different doses of dexmedetomidine including 0.7 μg.kg.h and 0.5 μg.kg.h in hypertensive patients undergoing laparoscopic cholecystectomy.

SETTINGS AND DESIGN

This was a randomized, prospective, double-blind controlled trial.

SUBJECTS AND METHODS

A total of 60 controlled hypertensive patients of either sex, aged 30-60 years, and ASA class 2 without any other serious comorbid conditions who were undergoing laparoscopic cholecystectomy under general anesthesia were randomly assigned into three groups of 20 each. Group A and B received loading dose of dexmedetomidine 1 μg.kg over 10 min and maintenance dose at 0.7 and 0.5 μg.kg.h, respectively. Group C received normal saline infusion only. Hemodynamic parameters (heart rate and systolic, diastolic, and mean arterial pressure) and sedation score were compared at different time intervals among groups.

STATISTICAL ANALYSIS USED

The Chi-square test, ANOVA, and Tukey Test.

RESULTS

Fluctuations in the hemodynamics of hypertensive patients are effectively attenuated by dexmedetomidine and there is no difference in the attenuation of these hemodynamic changes by maintenance dose of 0.5 or 0.7 μg.kg.h. However, maintenance dose of 0.5 μg.kg.h causes lesser sedation.

CONCLUSIONS

Dexmedetomidine administered as infusion in a maintenance dose of 0.5 μg.kg.h serves as an ideal anesthetic adjuvant in hypertensive patients undergoing laparoscopic cholecystectomy.