Assessment of the effect of dexmedetomidine in high risk cardiac patients undergoing laparoscopic cholecystectomy

Abstract

BackgroundLaparoscopy results in pathophysiologic changes and potentiates a neurohormonal stress response which increases systemic vascular resistance, mean arterial blood pressure, and heart rate and the aim of present study was to evaluate the effect of dexmedetomidine in high risk cardiac patients undergoing laparoscopic cholycystectomy.MethodsThe study included 80 patients [cardiac patient with ASA physical status III–IV], and scheduled for elective laparoscopic cholycystectomy. The patients were classified randomly into two groups: Group D: The patients received a loading dose of 1 μg/kg dexmedetomidine over 15 min before induction and maintained with 0.3 μg/kg/h infusion during the procedure. Group C: The patients received an equal volume of normal saline.ResultsThe heart rate increased greatly after induction in the control group compared to the group D (P < 0.05) and the heart rate remained elevated during the procedures and post-operatively. There was an attack of tachycardia affected 4 patients in group D and 10 patients in group C and the comparison was significant (P = 0.044). The mean arterial blood pressure increased greatly after induction in the control group compared to the group D (P < 0.05) and the mean arterial blood pressure remained elevated during the procedures and post-anesthesia care unit The total fentanyl dose was higher in the group C patients more than group D (P < 0.001). The end-tidal sevoflurane was lower in group D patients than group C patients (P < 0.001).ConclusionDexmedetomidine is safe for cardiac patients undergoing laparoscopic cholycystectomy. It minimized the changes in heart rate and blood pressure and decreased the total dose of fentanyl and end-tidal sevoflurane and the requirement for medications in high risk cardiac patients.