Study of haemodynamic changes during robotic urological surgeries: Comparison of dexmedetomidine and propofol

Abstract

Background: General anesthesia induces endocrine, immunologic, and metabolic responses. Certain anesthetic drugs affect the hemodynamic variables of the patient by various mechanism. The purpose of this study was to compare the effects of propofol and dexmedetomidine on hemodynamic parameters in robotic renal transplant surgery. Methods: This was a prospective comparative study performed in a tertiary care center. After local ethics committee approval and written informed consent, a total of fifty-two patients of ASA physical status 3 of either sex were randomly selected for this study. They were scheduled for elective robotic urological procedures of around three hours under general anaesthesia and divided into two groups (each group containing 26 patients). According to the haemodynamic requirement inj. dexmedetomidine maintainence(0.2 – 0.7mcg/kg/min) infusion and propofol(25 -75 mcg/kg/min) infusion started and maintained respectively. The measurements were taken on the same arm throughout the study at the following times: baseline,after loading dose,after intubation, after 20 min after the pneumoperitoneum, after 60 minutes of the pneumoperitoneum, after infusion stopped, after extubation. Results: Heart rate and mean atrial pressure changes were significantly lower in dexmedetomidine group in all stages compared to propofol group (P < 0.001). Also, the rises in blood glucose and serum epinephrine levels in the dexmedetomidine group were significantly higher than in the propofol group (P < 0.001). Conclusions: Anesthesia maintenance by dexmedetomidine showed a significant difference in hemodynamic parameters in comparison with propofol. While dexmedetomidine had better effects on controlling hemodynamic parameters, propofol showed better effects on decreasing stress hormones, and it can be suggested for LC surgery.