MAGNESIUM SULPHATE VERSUS DEXMEDETOMIDINE AS AN ADJUVANT TO BISPECTRAL INDEX GUIDED BALANCED GENERAL ANESTHESIA FOR LAPAROSCOPIC CHOLECYSTECTOMY: A NON-RANDOMIZED, DUAL-ARM, PROSPECTIVE STUDY
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Keywords
Magnesium sulphate, Dexmedetomidine, Propofol, Bi-spectral index, Laparoscopic cholecystectomy, Recovery profile, Ramsay Sedation Scale score, Modified Aldrete score
Abstract
Background: Magnesium sulphate and dexmedetomidine have been successfully used as an adjuvant to balanced general anesthesia. This study was designed to compare propofol-sparing effects, effects on haemodynamic changes and recovery profile due to intravenous magnesium sulfate and dexmedetomidine.
Methods: A prospective observational comparative study was conducted on 60 patients belonging to American Society of Anesthesiologists physical status 1to3, of either sex, in the age group of 18-60 years, undergoing laparoscopic cholecystectomy. Thirty patients who received magnesium-sulphate 40 mg/kg bolus in 100ml normal saline 15 minutes before induction followed by 10 mg/kg/h continuous infusion intra-operatively were included in group M, thirty patients who received dexmedetomidine 1 µg/kg bolus in 100ml normal saline followed by 0.5 µg/kg/h continuous infusion intra-operatively were included in group D. Induction and maintenance was done with propofol and atracurium. Vital parameters, neuromuscular blockage, bispectral-index (BIS) values, extubation time, time to follow verbal commands, modified Aldrete score and Ramsay Sedation Scale score were observed.
Results: Propofol requirement was significantly reduced in group D (P<0.001). Extubation time, time to follow verbal command, time to achieve BIS-value 80 & Aldrete score ≥ 9 were significantly faster in group M(P<0.05). RSS scores were significantly lower in group M (P<0.05). Intra-operative hemodynamics were comparable (P>0.05) with minimal side-effects in both groups.
Conclusion: Intravenous dexmedetomidine decreases propofol requirements intra-operatively, while intravenous magnesium-sulfate has a better recovery profile with less post-operative sedation. Intra-operative hemodynamics were comparable and side-effects were minimal in both groups.
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Dr. Ami Patel
Assistant Professor, Department of Anesthesia, Terna Medical College, Navi Mumbai, Maharashtra, India.
Dr. Bansari N. Kantharia
Additional Professor, Department of Anesthesia, Government Medical College, Surat, Gujarat, India.