COMPARISON OF EFFECT OF LOW DOSE DEXMEDETOMIDINE INFUSION (0.2 VS 0.4 MCG/KG/HR) ON HEMODYNAMIC STRESS RESPONSE IN PATIENTS UNDERGOING LAPROSCOPIC CHOLECYSTECTOMY UNDER GENERAL ANESTHESIA AT TERTIARY CARE HOSPITAL KARACHI
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Keywords
Anesthesia, Dexmedetomidine, Hemodynamic Response, Laparoscopic Cholecystectomy
Abstract
Background: Dexmedetomidine, an α2-adrenergic receptor agonist, has gained prominence for its hemodynamic stabilizing properties in anesthesia. Its dose-dependent effects on reducing stress responses during laparoscopic surgeries remain underexplored.
Objective: To compare the effects of low-dose dexmedetomidine infusion at 0.2 mcg/kg/h versus 0.4 mcg/kg/h on the hemodynamic stress response in patients undergoing laparoscopic cholecystectomy under general anesthesia.
Study Design and Setting: This randomized controlled trial was conducted from November 2020 to March 2021 at the Department of Anesthesiology, Civil Hospital Karachi.
Methodology: A total of 182 patients (91 per group) of ASA status ≤2, aged 20–60 years, were randomly assigned to receive dexmedetomidine infusions at 0.2 mcg/kg/h (Group A) or 0.4 mcg/kg/h (Group B). Hemodynamic parameters, including pulse rate (PR) and mean arterial pressure (MAP), were recorded at predefined intervals.
Results: Group B demonstrated significantly lower pulse rates and mean arterial pressures compared to Group A at all measured time points. For example, at 1 minute post-intubation, the pulse rate was 96.57 ± 3.52 in Group A versus 86.98 ± 1.06 in Group B (p = 0.001). Similarly, MAP was 101.1 ± 9.54 mmHg in Group A versus 94.69 ± 1.58 mmHg in Group B (p = 0.001). These differences persisted post-stratification for variables such as age, gender, BMI, and surgical duration.
Conclusion: A dexmedetomidine infusion at 0.4 mcg/kg/h is more effective in attenuating the hemodynamic stress response during laparoscopic cholecystectomy compared to 0.2 mcg/kg/h, with statistically significant reductions in pulse rate and mean arterial pressure.
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Muhammad Moazzam Ali
FCPS, MBBS Senior Registrar Anesthesia, Dow University of Health Sciences,
Maria Hashmi
FCPS, MBBS Senior Registrar Anaesthesia, Dow University of Health Sciences
Hubba Ahmed
FCPS, MBBS, Senior registrar Anaesthesia Dow University of Health and Sciences
Hajra Zafar Siddiqui
FCPS, MBBS, Senior Registrar Anaesthesia Sindh Institute of Urology and Transplantation
Umama Masnoon
FCPS, MBBS, Senior registrar Anaesthesia Dow University of Health and Sciences
Atif Shafqat
MBBS, MSc., MRCA, PhD, Assistant Professor & Consultant Department of Anesthesiology Dow University Hospital, DUHS, Karachi
Syed Farjad Sultan
MBBS, FCARCSI, PhD. Associate Professor Dow University of Health Sciences