Abstract
Study objectiveThe current study was conducted to compare the effect of perioperative administration of intravenous dexmedetomidine versus lidocaine on the perioperative hemodynamic changes, anesthetic consumption, anesthesia induction, and recovery times in patients undergoing elective abdominal gynecological surgeries under general anesthesia.Materials and methodsNinety female patients undergoing elective abdominal gynecological surgeries were enrolled in the current study. Patients were randomly distributed to one of three equal groups: group L received lidocaine (1.5 mg/kg loading, 2 mg/kg/h infusion), group D received dexmedetomidine (1 μg/kg loading, 0.5 μg/kg/h infusion), and group C received isotonic saline 0.9% in the same volume and pattern as the study drugs. Hemodynamic parameters including mean arterial pressure (MAP) and heart rate (HR), anesthetic consumption and induction, recovery times, and time to the first postoperative analgesic demand were recorded.ResultsThe MAP and HR after endotracheal intubation and in the subsequent recordings were significantly lower in group L and D when compared with group C with no significant difference between group D and L. The propofol induction dose and mean end-tidal isoflurane concentration were significantly lower in group L and D when compared with group C and were also significantly lower in group D when compared with group L. The intraoperative fentanyl consumption was significantly lower in group L and D when compared with group C with no significant difference between group D and L. The anesthesia induction time was significantly shorter in group L and D when compared with group C; it was also significantly shorter in group D when compared with group L with no significant difference as regards the anesthesia recovery time and the response time between the three study groups. The time to the first postoperative analgesic requirement was significantly longer in group D and L when compared with group C; it was also significantly longer in group D when compared with group L.ConclusionBoth dexmedetomidine and lidocaine could be a useful adjuvant to general anesthesia in patients undergoing abdominal gynecological surgeries. However, dexmedetomidine has a better sparing effect on intraoperative anesthetic consumption and longer time to the first postoperative analgesic demand than that of lidocaine with no significant difference between both agents on intraoperative analgesic demand.
Highlights
Dexmedetomidine, an imidazole compound, is the pharmacologically active dextroisomer of medetomidine that displays specific and selective α2-adrenoceptor agonism
The mean arterial pressure (MAP) decreased in the three study groups compared with postdrug bolus values to be significantly lower in group D and L when compared with group C with no significant difference between group D and L
The MAP was significantly lower in group D and L when compared with group C with no significant difference between group D and L for the remaining of the surgical time
Summary
Dexmedetomidine, an imidazole compound, is the pharmacologically active dextroisomer of medetomidine that displays specific and selective α2-adrenoceptor agonism. Activation of these receptors in the brain and spinal cord inhibits neuronal firing, causing hypotension, bradycardia, sedation, and analgesia (Gertler et al 2001). Systemic lidocaine used as a continuous infusion at the perioperative period has analgesic, antihyperalgesic, and anti-inflammatory properties which make it capable of reducing intra- and postoperative drug consumptions and patients’ hospital stay (Oliveira et al 2010a). The goal of the current study was to compare the effects of perioperative intravenous lidocaine and dexmedetomidine on the hemodynamic changes, anesthetic consumption, anesthesia induction, recovery times, and the time to the first postoperative analgesic requirement in patients who underwent elective abdominal gynecological surgeries under general anesthesia
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