“A COMPARATIVE STUDY OF ESMOLOL AND DEXMEDETOMIDINE ON HAEMODYNAMIC RESPONSES TO CARBON DIOXIDE PNEUMOPERITONEUM DURING LAPAROSCOPIC SURGERY.”

Abstract

Background: The advent of laparoscopic surgery has beneted the patient and surgeon, however creation of pneumoperitoneum for same has bearings during the perioperative period. These effects of pneumoperitoneum are associated with signicant haemodynamic changes, increasing the morbidity of the patient. Aim: The present study compared the efcacy of dexmedetomidine and esmolol on hemodynamic responses to CO2 pneumoperitoneum during laparoscopic surgery. Material And Method: A total of 60 patients aged 20-50 y, American Society of Anaesthesiologists (ASA) physical status I or II, of either sex, planned for laparoscopic surgery were included. The patients were randomly divided into two groups of 30 each. Group D received dexmedetomidine bolus dose 1 mcg/kg IV in 100 ml NS and Group E received esmolol bolus dose 1 mg/kg IV in 10 ml of NS before creating pneumoperitoneum. Measurement: Heart rate (HR), systolic blood pressure, diastolic blood pressure and mean arterial pressure (MAP) were recorded preoperative, vitals were recorded at intubation time, after intubation before creating pneumoperitoneum, after creating pneumoperitoneum, at 3,5,10 min and then every 10 min intervals till 30 min after pneumoperitoneum. Propofol induction dose, intraoperative fentanyl requirement and rescue drug were also recorded. Result: In group D, there was no statistically signicant increase in HR and blood pressure after pneumoperitoneum at any time intervals, whereas in Group E, there was a statistically signicant increase in MAP and HR after pneumoperitoneum at 10, 20, and 30 min. There was a signicant decrease in induction dose of propofol and intraoperative fentanyl requirement in Group D and E. Conclusion: Dexmedetomidine is more effective than esmolol for attenuating the hemodynamic response to pneumoperitoneum in elective laparoscopic surgery. Dexmedetomidine and esmolol also reduced requirements of anaesthetic agents