DOI: 10.36347/sjams.2019.v07i02.030

Pages: 577-583

Laparoscopic surgical procedure is minimally invasive technique which offers various benefits to the patient compared with the traditional open surgical procedures and is gaining importance in general surgery However creation of pneumoperitoneum has its own disadvantages in terms of adverse hemodynamic cardiovascular, respiratory, stress response.The present study aims to compare the efficacy of dexmedetomidine (α2 adrenrgic agonist) and esmolol (β1 receptor antagonist) on hemodynamic responses during laparoscopic cholecystectomy. The study was conducted as an open label single blind prospective randomized controlled study of 100 cases conducted over period of 1 year.100 patients belonging to American Society of Anaesthesiologist physical status I-II were assigned randomly into two groups of 50 patients.Group D was given Dexmedetomidine loading dose 1mcg/kg before induction and maintenance 0.5 mcg/kg/h throughout pneumoperitoneum and Group E was given Esmolol loading dose 1 mg/kg before induction and maintenance 50ug/kg/min throughout pneumoperitoneum. Heart rate,systolic blood pressure, diastolic blood pressure and mean arterial pressure were recorded preoperative, after study drug, after induction, after intubation, after pneumoperitoneum at 5 min intervals, post pneumoperitoneum and postextubation. In group D, there was no statistically significant increase in heart rate and blood pressure after pneumoperitoneum at any time intervals, whereas in Group E, there was a statistical significant increase in heart rate and blood pressure after pneumoperitoneum at various intervals during the whole pneumoperitoneum period. Dexmedetomidine loading dose 1ug/kg before induction and maintenance 0.5 ug/kg/h throughout pneumoperitoneum seems to be an attractive method to maintain hemodynamic stability in laparoscopic cholecystectomy without any side effects.