Comparative evaluation of dexmedetomidine and labetalol for attenuating hemodynamic stress responses during laparoscopic cholecystectomy in borderline hypertensive patients

Abstract

Abstract Objective Various pharmacological agents have been tried to attenuate the pressor response in laparoscopic cholecystectomy patients. We have compared single pre-induction intravenous injection of dexmedetomidine with labetalol for attenuation of hemodynamic stress response. Methods A total of 160 patients were considered for this prospective, randomised, double blind clinical study done in a single tertiary care institution. Patients were either included in group D, to receive 1.0 μg kg−1 i.v. dexmedetomidine or group L, to receive 0.3 mg kg−1 i.v. labetalol in 100 ml of normal saline before induction of anaesthesia. Patient's hemodynamic parameters were noted pre-operatively before starting infusion and at fixed intervals afterwards till extrubation. Results After intubation, mean systolic blood pressure (SBP) was higher in patients of group L (128.0 ± 13.866) as compared to group D (123.2 ± 10.672). Afterwards the SBP was comparable until extrubation. Similarly, after intubation patients in group D tended to have lower diastolic pressure (73.1 ± 9.683 vs. 79.2 ± 14.153, p value 0.0017) compared to patients in group L. Also, the relative incidence of bradycardia and hypotension was higher in patients who had received inj. labetalol. Conclusion In patients predisposed to significant fluctuations in blood pressure or heart rate dexmedetomidine may be more suitable than labetalol due to better preservation of normal hemodynamics especially during periods of stress showing a relatively lower incidence of side effects.