Effect of dexmedetomidine & clonidine on intracranial pressure with help of optic nerve sheath diameter during laparoscopic surgery

Abstract

Introduction: Laparoscopic surgeries are not uncommon these days. Laparoscopic cholecystectomy and appendicectomy are usually done at most centers. One major requirement in preparation for surgery is formation of pneumo-peritoneum by insufflation of carbon dioxide gas. Materials and Methods: The prospective randomized study conducted in the Department of Anaesthesia and Department of Surgery, GSVM Medical College, and Associate LLRM Hospital, Kanpur from January 2019 to March 2020 on patients admitted from outpatients department for elective laparoscopic surgery. After getting written consent from patients or relatives and approval from ethical committee study initiated. Enrolled patients were admitted in institute at least one day prior to surgery, Pre anesthetic checkup of the patient to be included in the study was done on evening before surgery. Patients were counseled regarding adequate NPO, sedation, the anaesthetic and operative procedure. Investigations were done according to the institution’s protocol. No hypnotic given to patients but tab Ranitidine 150mg and tab Alprazolam 0.25mg were give on night before surgery. Results: A total no of 70 patients in the age group of 18-55 years belonging to ASA grades I & II were enrolled in the study. They were divided into two groups (C and D) of 35 each. During observational study 3 patients dropped out from group C and 2 patients from group D due to poor quality of ocular sonography. 1 patient from group D was converted into open surgery. So, n=32 patients were taken for observation and result in both groups. Conclusion: We, hereby concluded with the help of the present study and available literature that premedication with Dexmedetomidine would be a better option than clonidine for laparoscopic surgeries in terms of intracranial pressure regulation (statistically significant p<0.01) and hemodynamic regulation. Less number of cases for study may be a limitation. So, study can be extended with big sample size for best result.