Volume: 2 Issue: 1
Year: 2014, Page: 3-10,
Background: Dexmedetomidine(Dex), an α2 adrenoreceptor agonist, is widely used in various clinical settings for its sympatholytic, sedative, anaesthetic sparing and haemodynamic stabilising properties without significant respiratory depression.
Objectives:The objective of this study is to evaluate the efficacy of dexmedetomidine in attenuating the sympathoadrenal response to tracheal intubation and reduction in requirements of propofol and fentanyl intra-operatively.
Materials and methods: Hundred patients scheduled for elective surgeries like thyroidectomy and abdominal surgeries for more than 3 hours duration were randomly divided into group C and group D with 50 patients in each group. The control group received isoflurane–opioid and study group received isoflurane–opioid-dexmedetomidine anaesthesia. Dexmedetomidine infusion in a dose of 1 μg/kg was given over 10 min before the induction of anaesthesia and was continued at a dose of 0.2–0.7 μg/kg/hour until skin closure. All patients were induced with propofol, fentanyl and vecuronium.Haemodynamic variables were continuously recorded.
Results: It was observed that dexmedetomidine effectively controlled the increase in heart rate following intubation compared to the control group 68.56 vs. 77.30 (p<0.0001). Reduction of mean a rt e ri a l p r e ss u r e w a s si g n ifi c a n t i n dexmedetomidine group compared to control group (p< 0.0001). Dexmedetomidine reduced the intraoperative use of propofol compared to control group 92.04 (2.84) mg vs. 112.20 (7.90) (p<0.0001) and fentanyl compared to control group 81.5 (2.31) vs.105.40 (9.08) (p<0.0001). Dexmedetomidine also reduced postoperative analgesic requirement significantly compared to control group.
Conclusion: Pe riope r a tive infusion of dexmedetomidine is effective in attenuating sympathoadrenal response to tracheal intubation. It has significant anaesthetic and opioid sparing effect.
Keywords: Dexmedetomidine, Stress response Analgesia, Tracheal intubation, Anaesthetic requirement
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