Effect of dexmedetomidine on hemodynamic changes during laryngoscopy, intubation, and perioperatively in laparoscopic surgeries

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INTRODUCTION: Laryngoscopy and intubation lead to mechanical and chemical stimuli, resulting in hypertension and tachycardia. The pneumoperitineum and CO2 insufflation with positional changes result in significant hemodynamic and respiratory changes. These sudden changes may lead to myocardial ischemia, pulmonary edema, and cerebral hemorrhage. Many modalities such as propofol infusion, beta-blocker, high-dose opioid, benzodiazepine, and vasodilators have been tried to obtund these changes. Dexmedetomidine is highly selective alpha-2 agonist, has been effective in attenuating sympathomimetic response during laryngoscopy, intubation as well as during laparoscopic surgeries. OBJECTIVE: In a randomized, prospective, double-blind, control study, we evaluate the safety and efficacy of single bolus intravenous dose followed by infusion of dexmedetomidine as compared to control group of normal saline in attenuating response to laryngoscopy, intubation, and pneumoperitoneum in laparoscopic surgeries. MATERIALS AND METHODS: A total of 60 patients of either sex aged 18–65 years scheduled for elective laparoscopic surgeries were randomly allocated in one of the two groups of thirty patients each. Group D received injection dexmedetomidine with loading dose 1 mcg/kg before induction over 10 min followed by maintenance dose of 0.2 mcg/kg/h. Group S serve as control group received normal saline in the same dose. RESULTS: It was observed that heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were significantly less after intubation and throughout the period of pneumoperitoneum. CONCLUSION: Dexmedetomidine is efficacious in attenuating the hemodynamic response to laryngoscopy, intubation, and pneumoperitoneum.