Anesthesia For Laparoscopic Cholecystectomy Research Articles

Comparison of Baska Mask Versus Endotracheal Tube for General Anesthesia in Laparoscopic Cholecystectomy: A Randomized Controlled Trial

: This study aimed to compare the Baska mask and the endotracheal tube, two devices used to manage patient airways during laparoscopic surgery. Fifty patients undergoing laparoscopic cholecystectomy were randomly assigned to receive either the Baska mask or the endotracheal tube. Data on patients’ demographic and physical status, as well as their heart rate, blood pressure, oxygen level, and ease of device insertion, were collected. The mean BMI for the Baska mask group was 24.68 kg/m² (± 4), and for the Endotracheal tube group, it was 24.83 kg/m² (± 4.14), showing no significant difference (P = 0.9768). However, significant differences were observed in hemodynamic parameters. Patients in the endotracheal tube group exhibited higher heart rates, blood pressure, and mean arterial pressure, indicating more cardiovascular stress than those in the Baska mask group. The endotracheal tube also caused more throat irritation, with more patients reporting post-surgery sore throat. The Baska mask was found to be easier and quicker to insert, requiring less skill and time. Both devices provided adequate oxygenation, but the endotracheal tube had more negative effects on the cardiovascular system and throat. In conclusion, the Baska mask could be a better alternative for laparoscopic surgery, improving both physiological parameters and patient comfort.

Efficacy of Segmental Thoracic Spinal Anaesthesia in Laparoscopic Cholecystectomy

Introduction: Segmental Thoracic Spinal Anesthesia (STSA) in Laparoscopic Cholecystectomy represents a significant advancement in the field of anesthesiology, offering a viable alternative to the traditional general anesthesia (GA) for this procedure. Aim of the study: The aim of this study was to assess the efficacy of segmental thoracic spinal anaesthesia in laparoscopic cholecystectomy. Methods: This prospective observational study, conducted at the Department of Anaesthesia, Analgesia and Intensive care medicine, Bangabandhu Sheikh Mujib Medical University, Dhaka, Bangladesh, from June to December 2023, included 60 patients undergoing laparoscopic cholecystectomy. They were divided into two groups of 30 each: Group A received segmental thoracic spinal anesthesia, and Group B underwent surgery under general anesthesia. Result: Group A and Group B were demographically similar, with no significant differences in age, sex, BMI, ASA grading, or cholecystectomy indications. Group A had a shorter anesthesia duration (83.0 ± 25.1 min) compared to Group B with 97.8 ± 29.5 min (p=0.0407). Surgical time and intraoperative fluid volume showed no significant difference. Group A experienced more bradycardia (13.3%) and shoulder pain (16.7%), while Group B had more nausea (13.3%) and hypotension (10%). Postoperatively, Group A had a shorter hospital stay and quicker recovery. Group A reported less shoulder pain (6.7% vs. 26.7%, p=0.0395) and no nausea. VAS scores were consistently lower in Group A at all postoperative times, indicating better pain management. Conclusion: The study conclusively demonstrates that thoracic segmental spinal anesthesia offers comparable significant advantages in laparoscopic cholecystectomy with shorter durations of anesthesia, quicker postoperative recovery, and reduced postoperative pain.

Randomised Controlled Clinical Trial of Spinal and General Anaesthesia in Laparoscopic Cholecystectomy

Randomised Controlled Clinical Trial of Spinal and General Anaesthesia in Laparoscopic Cholecystectomy

Management of Anesthesia in Laparoscopic Cholecystectomy During First Trimester Pregnancy

Pregnant women increase the risk of gallbladder disease. Acute cholecystitis occurs 1-6 per 10.000 pregnancy and Cholecystectomy is the second most frequent procedure in pregnancy. Biliary stasis and biliary smooth muscle relaxation due to elevated estrogen and progesterone hormones during pregnancy can lead to gallstones formation. Cholelithiasis complications associated with choledocholithiasis, acute cholecystitis, cholangitis and, gallstone pancreatitis that posing significant morbidity and mortality like spontaneous abortion, preterm labor, and fetal loss. Laparoscopic surgical techniques are no longer a contraindication to non-obstetric surgery for pregnant women although they still have a risk of developing fetal development disorders. Management of anesthesia in laparoscopic cholecystectomy during pregnancy must consider the risk of anesthesia surgery, from the disease, maternal and fetal condition, and manipulation when surgeon performing laparoscopic. This report presenting a 33-years-old woman with 10-week pregnancy who undergoes laparoscopic cholecystectomy followed by symptomatic cholelithiases. It was done with general anesthesia combined with epidural analgesia. After the procedure, there is no complaint about abdominal pain or vaginal bleeding. The patient was discharged 3 days aftercare.

Efficacy and safety of segmental spinal anaesthesia in laparoscopic cholecystectomy: A prospective study

Laparoscopic cholecystectomy is usually conducted under general anaesthesia(GA) which has its own limitations and may be associated with certain complications. This single-arm prospective interventional study was done to assess the safety and efficacy of thoracic segmental spinal anaesthesia(TSSA) as a sole anaesthetic procedure in patients undergoing laparoscopic cholecystectomy. TSSA was administered to 50 patients of the American Society of Anaesthesiologists physical status 1, 2, 3, who were scheduled for elective laparoscopic cholecystectomy (1.5 ml of 0.75% ropivacaine with dexmedetomidine 6 µg as an adjuvant was injected in one of the intervertebral spaces between T7- T12). The primary objective of the study was to evaluate the efficacy and safety of TSSA to provide complete surgical anaesthesia in terms of the total number of cases converted to GA. The data was analysed using SciPy(version 1.3.1), a statistical analysis package, in Python programming language (version 3.7.4). Our study revealed that TSSA provided complete surgical anaesthesia in 48 patients and in two patients there was a failure to achieve adequate sensory block and GA had to be administered. The median time for full sensory regression was 90 min and the median time for complete motor regression was 60 min. No major intraop or postop adverse event was noted.TSSA offers safe and satisfying operating conditions for elective laparoscopic cholecystectomy. This technique practised with caution can provide a useful alternative to GA, especially in conditions where GA may have limitations.

Intraoperative Target-Controlled Infusion of Etomidate versus Propofol for General Anesthesia in Laparoscopic Cholecystectomy

To investigate the safety and changes of hemodynamic profiles when using etomidate for general anesthesia in laparoscopic cholecystectomy compared to propofol was the objective of the study. Adult patients who received laparoscopic cholecystectomy were retrospectively categorized as etomidate and propofol group. Time to extubation, time to eye opening, pain scores at rest, postoperative nausea, vomiting and lengths of hospital stay were studied as safety outcomes. Changes in hemodynamic profiles are evaluated by coefficients of variation of systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rates were compared between groups. 291 patients were categorized as the etomidate group and 388 patients as the propofol group. There was no significant difference in age, sex, body mass index and hemodynamic profiles at baseline between the two groups (p all>0.05). Compared to propofol, the etomidate group showed similar safety outcomes (p all>0.05). Similar change patterns in the hemodynamic profiles over time were observed between the two groups, but the coefficients of variation of systolic blood pressure, diastolic blood pressure and mean arterial pressure in the etomidate group were significantly lower than that in the propofol group (p<0.05). There was no difference in safety outcomes but a more stable hemodynamic profile when comparing intraoperative target-controlled infusion of etomidate to propofol used for general anesthesia in laparoscopic cholecystectomy.

A comparative evaluation of butorphanol, fentanyl and nalbuphine for total intravenous anaesthesia in laparoscopic cholecystectomy

Introduction: The study compared the effectiveness of opioids: butorphanol, fentanyl and nalbuphine as a part of Total Intra Venous Anaesthesia (TIVA) using propofol as an inducing agent in all three groups in laparoscopic cholecystectomy in view of haemodynamic stability, analgesia and recovery characteristics. Aims: To compare the efficacy of opioids viz. butorphanol, fentanyl and nalbuphine as a part of TIVA using propofol as an inducing agent in all the three groups in laparoscopic cholecystectomy in view of Haemodynamics variables, analgesia and recovery characteristics. Material and Methods: This randomised prospective study was conducted in ninety patients of ASA grade I of either sex, in the age group of 20- 60 yrs and weighing 30- 70 kg undergoing laparoscopic cholecystectomy. Patients in group I received 25 μg/kg of inj. butorphanol intravenously, group II received 2 μg/kg of inj. fentanyl intravenously and group III received 0.3 mg/kg of inj. nalbuphine intravenously just before induction of anaesthesia. Induction was carried out exclusively with IV agents with inj. propofol 2 mg/kg and inj. vecuronium bromide 100μg/kg intravenously. Anaesthesia was maintained with TIVA using propofol infusion according to the Bristol infusion regimen and intermittent top-up doses of muscle relaxant. Haemodynamic monitoring, recovery characteristics in form of emergence time and recovery time, duration of analgesia, sedation and any side effects were recorded. Results: In our study, it was found that butorphanol maintained a better steady state of haemodynamics throughout the intraoperative period as compared to fentanyl and nalbuphine. The attenuation of pressor response was again better with butorphanol, although fentanyl also suppressed this response to some extent. In view of recovery parameters, butorphanol and nalbuphine showed slow recovery in comparison to fentanyl whereas butorphanol provided better analgesia than the other two drugs. Conclusion: To conclude, the study demonstrated the agonist-antagonist type of opioids can be a suitable alternative to the scheduled agonist opioids like fentanyl.

COMPARISON BETWEEN TOTAL INTRAVENOUS ANESTHESIA (TIVA) WITH PROPOFOL – FENTANYL AND BALANCED ANESTHESIA WITH SEVOFLURANE – FENTANYL IN TERMS OF HEMODYNAMIC CHANGES AND RECOVERY PROFILES DURING LAPAROSCOPIC CHOLECYSTECTOMY

Background: Sevoflurane and propofol are considered to be the agents of choice in laparoscopic surgery due to their smooth induction of anesthesia, hemodynamic stability, better recovery profile and less postoperative complications. The aim of study is to compare hemodynamic changes and recovery profile of propofol with sevoflurane-based anesthesia in laparoscopic cholecystectomy. Methods: Single blind comparative study was conducted among 132 patients aged 18-65 years, ASA-PS I &amp; II undergoing laparoscopic cholecystectomy, randomized by computer generated random number table into two groups, 66 patients each- Group A patients induced with propofol 1.5-2.5 mg/kg IV and maintained with propofol 100-200 mcg/kg/min IV and Group B induced with sevoflurane and maintained with sevoflurane at minimum alveolar concentration of 0.7-1.3. Primary outcome were hemodynamic parameters (heart rate, systolic and diastolic blood pressure, mean arterial pressure) and recovery profile. Results: Intraoperative heart rate and diastolic blood pressure were comparable between two groups at all times while there was a significantly lower systolic blood pressure only at 3 and 5 minutes after intubation in group B compared to group A (p &lt; 0.05). Recovery profiles assessed in terms of time of eye opening (657.89 ± 172.30 s vs 453.58 ± 157.49 s), obeying command (696.79 ± 192.44s vs 481.06±164.96s), and time of extubation (706.41±166.27s vs 483.38±160.62s) were significantly faster in group B (p value &lt; 0.001). Conclusions: Hemodynamic changes were comparable between propofol group and sevoflurane group while sevoflurane group had faster recovery.

Postoperative Nausea and Vomiting in Opioid-Free Anesthesia Versus Opioid Based Anesthesia in Laparoscopic Cholecystectomy.

Background: Postoperative nausea and vomiting (PONV) is a usual complication in patients undergoing laparoscopic cholecystectomy. Minimized opioid use due to surgery has been shown to have a better effect on patient recovery after surgery. In this study we evaluate the effect of opioid free anesthesia for postoperative nausea and vomiting in laparoscopic cholecystectomy. Materials and methods: 80 patients aged 20-65 years old were included in this randomized, clinical and prospective trial. The patients belonged to the ASA classifications 1 and 2 and were scheduled for laparoscopic cholecystectomy. Patients were classified into two groups: group 1 (fentanyl group- FG), which included 40 patients who received opioid anesthesia, and group 2 (opioid free anesthesia group-OFAG) which included 40 patients who received opioid free anesthesia. In patients from group 1 (fentanyl group -FG) introduction to general anesthesia consisted of giving midazolam at 0.04 mg/kg, fentanyl at 0.002 mg/kg, 2 mg/kg of propofol and 0.6 mg/kg of rocuronium bromide. These patients received fractionated bolus doses of fentanyl during surgery. Prior to general anesthesia these patients did not receive dexamethasone. The patients from group 2 (opioid free anesthesia group - OFAG) received dexamethasone at 0.1 mg/kg and 1 g of paracetamol before introduction to anesthesia as a pre-emptive analgesia. Introduction to anesthesia consisted of giving midazolam at 0.04 mg/kg, lidocaine at 1 mg/kg, propofol at 2 mg/kg, ketamine at 0.5 mg/kg, and 0.6 mg/kg of rocuronium bromide. Immediately after intubation, continuous intravenous infusion with lidocaine at 2 mg/kg/h and magnesium sulfate at 1.5 g/h was given. In this group, fentanyl was not given either during the introduction of anesthesia or during the intraoperative period. Immediately after extraction of the gallbladder patients from group 2 (OFAG) received 2.5 g of metamizole intravenously. PONV were recorded in the postoperative period of 24 hours after surgery. Results: There was no significant difference with respect to age, weight, sex, duration of surgery, and anesthesia time. PONV at different time intervals were statistically not significant at all postoperative time points - 1 hr, 4 hr, 8 hr, 12 hr and 24 hr after surgery in fentanyl group compared to opioid free anesthesia group. Even not statistically significant, PONV have occurred more often in patients who received opioid anesthesia. Conclusion: Postoperative nausea and vomiting occurs more often in patients who received opioids during laparoscopic cholecystectomy compared to patients who received opioid free anesthesia, but without statistical significance.

Author’s Response to Letter to the Editor: Is Opioid-Free General Anesthesia More Superior for Postoperative Pain Versus Opioid General Anesthesia in Laparoscopic Cholecystectomy?

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Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia

Introduction: Cholelithiasis or gallstones are hardened deposits of digestive fluid that can form in gallbladder. The treatment of gallstones depends upon the stage of disease. Once gallstones become symptomatic, definitive surgical intervention with cholecystectomy is usually indicated (typically, laparoscopic cholecystectomy is the first-line therapy). Laparoscopic cholecystectomy removes the gallbladder and gallstones through several small incisions in the abdomen. This case report aims to discuss the managent of segmental thoracic spinal anesthesia in laparoscopic cholecystectomy.&#x0D; Case: We report on the cases of 2 patients who undego elective laparoscopic cholecystectomy. Female, 53 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesiatechnique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 1,2 mcg target control infusion (TCI) propofol intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 100 cc, hemodynamically stable. Female, 42 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesia technique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 3 mg of midazolam intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 150 cc, hemodynamically stable. The level and duration of sensory block, intensity and duration of motor block were recorded. A 20 % or more decrease in MAP compared to baseline was considered as hypotension, iv ephedrine 5 mgr bolus administreted.&#x0D; Conclusion: Laparoscopy is a surgical procedure that uses minimally invasive surgical techniques (minimally invasive surgery) where the doctor uses a small telescope / camera that is inserted into the stomach and surgical instruments in mini form. This procedure has many advantages because it is not invasive, the amount of bleeding can be reduced, postoperative pain can be minimized. Regional anesthesia procedure in laparoscopic cholecystectomy based on several studies and case reports can be performed and is a safe procedure.

Clinical Effect Analysis of Different Anesthesia in Laparoscopic Cholecystectomy

Clinical Effect Analysis of Different Anesthesia in Laparoscopic Cholecystectomy

The Value of Combined Application of Oxycodone Hydrochloride Injection and Dexmedetomidine in Anesthesia for LC for Patients with Gallbladder Lesions.

Objective To analyze the effect of combined application of oxycodone hydrochloride injection and dexmedetomidine in anesthesia for laparoscopic cholecystectomy (LC) for patients with gallbladder lesions. Method 93 patients with gallbladder lesions in our hospital were divided into 2 groups by the random number table method. 46 patients in the control group applied oxycodone hydrochloride injection in anesthesia, and 47 patients in the observation group applied oxycodone hydrochloride injection combined with dexmedetomidine in anesthesia. Result The T1 and T2 MAP levels in the observation group were lower than those in the control group (P < 0.05), and the difference between T3 and the control group was not significantly significant (P > 0.05). The T1 to T3 HR level in the observation group were lower than those in the control group (P < 0.05). The rate of excessive sedation (10.64%) and sedation inefficiency (12.77%) in the observation group was lower than that in the control group (28.26% and 30.43%), and the rate of satisfactory sedation (76.60%) was higher than that in the control group (41.30%) (P < 0.05). The postoperative awakening, tracheal tube removal, and first anal venting time were shorter in the observation group than in the control group (P < 0.05). The WHO scores of incisional pain at 6, 12, 24, and 48 hours after the operation were lower in the observation group than in the control group (P < 0.05). The T2 SOD level in the observation group was higher than that in the control group, and the ROS and MDA levels were lower than those in the control group (P < 0.05). The incidence of side effects of anesthetic in the observation group was 17.02%, which was not statistically different from the control group of 13.04% (P > 0.05). Conclusion The combined application of oxycodone hydrochloride injection and dexmedetomidine in anesthesia for LC for patients with gallbladder lesions can achieve better sedation and analgesia effect, accelerate postoperative awakening and recovery, and control oxidative stress and fluctuations in signs, without increasing anesthesia-related side effects.

Spinal Anesthesia in Laparoscopic Cholecystectomy: A Cohort Study of 1762 Cases in Southeastern Mexico

Spinal Anesthesia in Laparoscopic Cholecystectomy: A Cohort Study of 1762 Cases in Southeastern Mexico

Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia

Introduction: Cholelithiasis or gallstones are hardened deposits of digestive fluid that can form in gallbladder. The treatment of gallstones depends upon the stage of disease. Once gallstones become symptomatic, definitive surgical intervention with cholecystectomy is usually indicated (typically, laparoscopic cholecystectomy is the first-line therapy). Laparoscopic cholecystectomy removes the gallbladder and gallstones through several small incisions in the abdomen. This case report aims to discuss the managent of segmental thoracic spinal anesthesia in laparoscopic cholecystectomy.&#x0D; Case: We report on the cases of 2 patients who undego elective laparoscopic cholecystectomy. Female, 53 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesia technique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 1,2 mcg target control infusion (TCI) propofol intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 100 cc, hemodynamically stable. Female, 42 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesia technique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 3 mg of midazolam intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 150 cc, hemodynamically stable. The level and duration of sensory block, intensity and duration of motor block were recorded. A 20 % or more decrease in MAP compared to baseline was considered as hypotension, iv ephedrine 5 mgr bolus administreted.&#x0D; Conclusion: Laparoscopy is a surgical procedure that uses minimally invasive surgical techniques (minimally invasive surgery) where the doctor uses a small telescope / camera that is inserted into the stomach and surgical instruments in mini form. This procedure has many advantages because it is not invasive, the amount of bleeding can be reduced, postoperative pain can be minimized. Regional anesthesia procedure in laparoscopic cholecystectomy based on several studies and case reports can be performed and is a safe procedure.

Laparoscopic Cholecystectomy under Segmental Thoracic Spinal Anesthesia

Introduction: Cholelithiasis or gallstones are hardened deposits of digestive fluid that can form in gallbladder. The treatment of gallstones depends upon the stage of disease. Once gallstones become symptomatic, definitive surgical intervention with cholecystectomy is usually indicated (typically, laparoscopic cholecystectomy is the first-line therapy). Laparoscopic cholecystectomy removes the gallbladder and gallstones through several small incisions in the abdomen. This case report aims to discuss the managent of segmental thoracic spinal anesthesia in laparoscopic cholecystectomy.&#x0D; Case: We report on the cases of 2 patients who undego elective laparoscopic cholecystectomy. Female, 53 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesia technique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 1,2 mcg target control infusion (TCI) propofol intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 100 cc, hemodynamically stable. Female, 42 years old, will undergo laparoscopic cholecystectomy, performed anesthesia with segmental thoracic spinal anesthesia technique using the anesthetic agent 3 ml of Levobupivacaine 0,5% + 25 mcg of Fentanyl, requiring a sensory block to at least T10-T11 dermatom. Patients received a 3 mg of midazolam intravenous is administered as intermittent boluses to achieve deep sedation. The operation lasts 1 hour, with a bleeding 15 cc and urine output 150 cc, hemodynamically stable. The level and duration of sensory block, intensity and duration of motor block were recorded. A 20 % or more decrease in MAP compared to baseline was considered as hypotension, iv ephedrine 5 mgr bolus administreted.&#x0D; Conclusion: Laparoscopy is a surgical procedure that uses minimally invasive surgical techniques (minimally invasive surgery) where the doctor uses a small telescope / camera that is inserted into the stomach and surgical instruments in mini form. This procedure has many advantages because it is not invasive, the amount of bleeding can be reduced, postoperative pain can be minimized. Regional anesthesia procedure in laparoscopic cholecystectomy based on several studies and case reports can be performed and is a safe procedure.

Comparison between Using Bupivacaine 0.5% and Bupivacaine with Sodium Bicarbonate 8.4 % in Thoracic Epidural Anesthesia for Laparoscopic Cholecystectomy

Background: Thoracic epidural anesthesia for LC is a satisfactory alternative technique in selected cases,therefore aim of current study was compare the deference between using of bupivacaine 0.5% at one andbupivacaine 0.5%. With sodium Bicarbonate 8.4 %. The differences we deal with there are onset of action.Duration of action, Potency, and the occurrence of complications. We report the sex, Age and smoking to seewe these factors can affecting the study ornot.Patients and Method: The sample contain 2 groups of patient each group involved 20 patent with deferentage and sex. Group A receive Bupivacaine 0.5% 12ml alone for thoracic epidural anesthesia at level of T6 forlaparoscopic. Cholecystectomy while ingroup B, we give Bupivacaine 0.5% 12ml with sodium bicarbonate8.4 % 5ml (420mg) for the same operation at the same level of injection. In both groups we put the epiduralcatheter for addition of more dose of Bupivacaine and the mixture if the action of drug is finish and for thepostoperative pain management after the operation.

Desflurane versus sevoflurane in laparoscopic cholecystectomy: A comparison of recovery profile and home discharge in Indian patients

Context: Laparoscopic cholecystectomy is one of the most commonly performed minimal access surgeries nationwide, safely done as a day care procedure. Anesthetic techniques facilitating early recovery and home discharge have become the need of the hour. Aims: To compare early, intermediate, late recovery characteristics and time to home readiness following use of sevoflurane or desflurane as maintenance anesthesia in laparoscopic cholecystectomy in Indian subpopulation. In addition, postoperative complications such as coughing and shivering and total antiemetic and analgesic requirements postoperatively were also noted. Settings and Design: This was a prospective randomized study, and randomization was done by computerized random number table into two groups (30 patients in each group). Group S received sevoflurane and Group D received desflurane as maintenance agent. Subjects and Methods: Sixty patients of age group 18–60 years belonging to the American Society of Anesthesiologists Grade I and II undergoing laparoscopic cholecystectomy were recruited. A standard anesthesia induction was done and airway was secured with a ProSeal laryngeal mask airway of appropriate size. The patients subsequently received either sevoflurane 1%–2% or desflurane 3%–6% with 60% N2 O in O2 as per group assigned. Inhalational agent was discontinued at the time of endoscope removal. Early, intermediate, and late recovery parameters were noted. Statistical Analysis: The tests of significance used were parametric test (unpaired t-test) and ANOVA. The outcome measures were compared statistically using unpaired t-test and ANOVA, and P < 0.05 was considered statistically significant. Results: Early recovery parameters were achieved faster in patients receiving desflurane as compared to sevoflurane with no difference in time to achieve intermediate recovery and home readiness. Conclusion: Despite a faster early recovery with desflurane, no additional benefit in terms of home discharge and patient satisfaction was found, thus making use of either of the agents suitable for laparoscopic cholecystectomy on a day care basis.

Dexmedetomidine as a Single Bolus Dose in Laparoscopic Cholecystectomy under General Anesthesia – A Comparison of Different Doses

Introduction: Dexmedetomidine has an ideal pharmacodynamic profile for attenuation of stress response during general anesthesia for laparoscopic cholecystectomy. Since, the value of dexmedetomidine as a single premedication dose remains largely unexplored, this study compared dexmedetomidine in 0.5μg/kg and 1μg/kg dose for laparoscopic cholecystectomy under general anesthesia. &#x0D; Objectives: The primary objective of this study was to compare dexmedetomidine in a single premedication dose of 0.5μg/kg and 1μg/kg in terms of hemodynamic (heart rate and mean arterial pressure) changes to critical incidences such as laryngoscopy, endotracheal intubation, pneumoperitoneum and extubation. The secondary objectives were to compare induction dose of propofol required, sedation scores in the immediate post anesthesia period and adverse events such as bradycardia and hypotension. &#x0D; Methodology: This was a prospective double blind study. Ninety-two patients aged 18-55 years of either gender of American Society of Anesthesiologists physical status I-II were randomly allocated into two groups to receive either Dexmedetomidine 1μg/kg or 0.5μg/kg slowly IV over 10 minutes as a premedication before induction. Heart rate, Mean arterial pressure, induction dose of propofol, sedation scores, and adverse events were compared. &#x0D; Results: The patient characteristics, Fentanyl consumption, duration of surgery and anesthesia in both groups were comparable. There was comparable attenuation of hemodynamics in both groups during laryngoscopy and intubation. Dexmedetomidine in 1μg/kg compared to 0.5μg/kg had significantly better attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum. After 40 minutes, there was no attenuation in either group. The post anesthesia sedation scores were comparable. The induction dose of propofol was significantly less and the incidence of bradycardia was significantly higher with dexmedetomidine 1μg/kg. &#x0D; Conclusion This study demonstrates that a premedication dose of Dexmedetomidine in 1μg/kg compared to 0.5μg/kg has significantly betier attenuation of hemodynamics from 1 minute to 40 minutes of pneumoperitoneum.

Effects of intravenous Dexmedetomidine on Intraoperative Hemodynamic Parameters in the Patients Undergoing Laparoscopic Cholecystectomy

Background: Dexmedetomidine, in addition to sympatholytic effect, diminishes intraoperative requirement of anesthetics including propofol. The present study was conducted to evaluate the effects of intravenous dexmedetomidine on intraoperative hemodynamics in laparoscopic cholecystectomy. Subjects and Methods: Five patients undergoing laparoscopic cholecystectomy received dexmedetomidine. Dexmedeto- midine was loaded (1 µg/kg) before anesthesia induction and infused (0.6 µg/kg/h) during surgery. Anesthesia was induced with propofol. Mean arterial pressure (MAP) and heart rate (HR) were recorded at baseline and at various time points from the loading of drugs to just after tracheal extubation. Results: Both HR and MAPdecreased till insufflation and then increased at extubation. Conclusion: During propofol-based anesthesia for laparoscopic cholecystectomy, dexmedetomidine provides stable intraoperative hemodynamics.