Comparative evaluation of the hemodynamic effects of inclusion versus exclusion of dexmedetomidine to pregabalin and fentanyl premedication regimen during airway instrumentation in laparoscopic abdominal surgeries

Abstract

Background: Airway instrumentation leads to an aggravated hemodynamic response due to increased sympathetic activity, imposing a risk of myocardial ischemia. A premedication regimen using fentanyl and pregabalin blunts the pressure response but not the rate response. Objective: To compare the effects of pregabalin and fentanyl regimen versus pregabalin, fentanyl, and dexmedetomidine regimen on the hemodynamic pressor response during airway instrumentation in laparoscopic abdominal surgery (LAS). Methods: Sixty patients (ASA I and II), undergoing elective LASunder general anesthesia, were randomly divided into 2 groups - Group A (n=30) premedicated with oral pregabalin (150mg) and IV fentanyl (2μg/kg) and Group B (n=30) premedicated with IV dexmedetomidine (0.25μg/kg) in addition to pregabalin-fentanyl regimen. Both groups were managed with the same anesthetic protocol. The preoperative sedation level was assessed before induction. The heart rate (HR), systolic and diastolic BP (SBP, DBP), and mean arterial pressure (MAP) were recorded at baseline as well as preoperatively, prior to intubation and at 1, 3, 5, 10, and 15 min after intubation. Results: Both groups had similar distribution of age, weight, gender, physical status, sedation level as well as intra-operative fentanyl and postoperative analgesic requirements.