Abstract
Introduction: Dexmedetomidine is a drug that can be used for various anaesthetic indications such as an adjuvant for general anaesthesia and regional blocks, in premedication, as a hypnotic and analgesic postoperatively. Aim: To study the effect of dexmedetomidine as an adjuvant in anaesthesia for laparoscopic surgery using entropy as an instrument to monitor the anaesthetic depth. Methods and materials: Sixty patients were enrolled for the study, thirty receiving dexmedetomidine infusion (group 1) and thirty receiving saline infusion (group 2). Prior to induction, an entropy sensor was positioned as per manufacturer’s recommendation. Patients received a loading dose of given drug, either dexmedetomidine or saline, followed by an infusion for maintenance. All patients were given general anaesthesia with propofol and fentanyl. The given drug infusion was continued until extubation. Results: Mean systolic and diastolic blood pressure during extubation showed 5% and 8.5% increase respectively from baseline in the dexmedetomidine group (p>0.050) as compared to 19% and 15% increase respectively in the saline group which was significant (p Conclusion: Dexmedetomidine is an effectual anaesthetic adjunct that can be used in laparoscopic surgeries with an excellent recovery profile and provides adequate depth of anaesthesia.
Highlights
Dexmedetomidine is a drug that can be used for various anaesthetic indications such as an adjuvant for general anaesthesia and regional blocks, in premedication, as a hypnotic and analgesic postoperatively
Induction was done with 5mg IV titrated doses of propofol until the entropy value of 40-60 was reached. 1mg/kg i.v. rocuronium was used as muscle relaxant
Intraoperative anaesthetic requirement was gauged by heart rate (HR) and blood pressure (BP), end point for requirement for both was considered a 20% increase from baseline value, and state entropy (SE) value, while the analgesic requirement was titrated with response entropy (RE), with an aim to maintain both RE and SE around 4060
Summary
Dexmedetomidine is a drug that can be used for various anaesthetic indications such as an adjuvant for general anaesthesia and regional blocks, in premedication, as a hypnotic and analgesic postoperatively. It can be used for effective premedication, attenuation of the laryngoscopic response and prevention of emergence delirium.[2] It provides superior analgesia after surgery and decrease in opioid requirements.[3,4] It has minimum alveolar concentration (MAC) sparing properties[5], decreases the incidence of postoperative nausea and vomiting (PONV), reduces metabolic demand of oxygen postoperatively which is helpful in cardiac patients and attenuates post-operative shivering.[6].
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