A study to compare the efficacy of dexmedetomidine with esmolol on haemodynamic response during laparoscopic cholecystectomy

Abstract

Background: Laparoscopic surgery is a routinely performed surgery and it is desirable to have a stable intraoperative haemodynamic states by avoiding hypertension and tachycardia. Various drugs have been employed to attenuate these hemodynamic response. No single drug is satisfactory. Thus there is a need to find a simple efficient and reliably consistent method. Aims: The purpose of study is to compare the efficacy of dexmedetomidine with esmolol on haemodynamic response to pneumoperitoneum during laparoscopic cholecystectomy. Materials and methods: Prospective, randomized, controlled, single blinded study was conducted in department of Anaesthesiology on 60 patients aged between 20-60 years posted for elective laparoscopic cholecystectomy. They were randomly divided into two groups of 30 patients each Group-A(Dexmedetomidine + Standard Procedure) and Group-B(Esmolol + Standard Procedure)- The Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Mean arterial pressure (MAP) were recorded prior to induction, after the induction, after the intubation, 15 min, 30 min, 45 min, 60 min after creation of pneumoperitoneum, post pneumoperitoneum, after extubation. Results: Heart rate and systolic blood pressure were significantly lower in Group A after induction, after intubation, and maintained throughout intraoperative and postoperative period compared to Group B. Diastolic blood pressure were significantly lower in Group A after intubation, and maintained throughout intraoperative period and at extubation compared to Group B. Diastolic blood pressure were not significant after induction, at postoperative period. Mean blood pressure were significantly lower in Group A after induction, after intubation, and maintained throughout intraoperative period and at extubation compared to Group B. Mean blood pressure were not significant at postoperative period. Conclusion: Dexmedetomidine(1mcg/kg followed by o0.5mcg/kg/hr) is more effective agent than esmolol(1mg/kg followed by 0.5mg/kg) in attenuation of hemodynamic response to intubation and reduces the elevation of heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure during and after pneumoperitoneum in laparoscopic cholecystectomy.