A Prospective, Randomized, Single-Blind, Comparative Study of Dexmedetomidine and Propofol Infusion for Intraoperative Hemodynamics and Recovery Characteristics in Laparoscopic Surgeries.

Abstract

Background:Creation of pneumoperitoneum in laparoscopic surgeries with carbondioxide to intra-abdominal pressures higher than 10 mmHg induces significant alterations of hemodynamics. To counteract, propofol or dexmedetomidine was compared and postoperative recovery assessed.Aims:The aim of this study was to compare the efficacy of standard dose of propofol versus low-dose dexmedetomidine as infusions to limit hemodynamic instability with pneumoperitoneum and facilitate recovery.Settings and Design:This was a prospective, randomized, single-blind, comparative study.Materials and Methods:Seventy patients between 18 and 60 years belonging to the American Society of Anesthesiologists Physical Status Class 1 and 2 scheduled for laparoscopic surgeries were randomly divided – Group D: To receive dexmedetomidine 1 μg/kg over 10 min before and 0.2 μg/kg/h infusion after intubation till the end of pneumoperitoneum and Group P: To receive propofol 100 μg/kg/min after intubation till the end of pneumoperitoneum. Variables such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline, preinduction, after loading dose of dexmedetomidine, postinduction, postintubation, at pneumoperitoneum, every 15 min till the end of surgery, at extubation, and postoperatively for 2 h monitored with Ramsay Sedation Scale and modified Aldrete's score.Results:Hemodynamic stability was better maintained in Group D than Group P with significant attenuation of hemodynamic stress response to pneumoperitoneum in terms of HR (3% decrease vs. 18% increase), SBP (5% decrease vs. 12% increase), DBP (2%increase vs. 16% increase), and MAP (4% decrease vs. 7% increase). Postoperatively, significant sedation was noted till 90 min in Group D and recovery was better in Group P.Conclusion:With doses of test drug infusion used, there is better attenuation of hemodynamic stress response to pneumoperitoneum with dexmedetomidine and faster recovery with propofol.