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IP International Journal of Aesthetic and Health Rejuvenation


A comparative study of balanced anaesthesia with dexmedetomidine added desflurane or sevoflurane in laparoscopic surgery


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Research Article

Author Details : Jasmine Singh*, Reema Vansola

Volume : 3, Issue : 1, Year : 2020

Article Page : 2-8


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Abstract

Introduction: Laparoscopic surgery is minimally invasive technique. Dexmedetomidine,selectively acts on the alpha 2 receptors in the locus ceruleus, produces sedation and anxiolysis. The intravenous administration of dexmedetomidine before induction of anesthesia attenuates sympathoadrenal responses and provides better hemodynamic stability intraoperatively due to its hypnotic, sedative, anxiolytic, sympatholytic and analgesic properties.. Desflurane and sevoflurane are both fluorinated inhalational anaesthetics characterized by a low blood/gas partition coefficient that favours rapid emergence as compared to other inhalational agents..
Aims and objectives: To compare intra operative hemodynamic stability with dexmedetomidine added to withdesflurane or sevoflurane. To compare extubation time required after discontinuation of desflurane or sevoflurane and dexmedetomidine.
Material and Methods: After obtaining permission from the Institutional ethical committee, a prospective randomized comparative study was carried out After obtaining written informed consent, eighty patients of ASA physical Status I -II aged between 14 to 60 years of either sex who were scheduled for various laparoscopic surgeries under general anesthesia were selected.
After pre-anaesthetic checkup before surgery and all the routine and specific investigations were done and documented.
Patients were randomly allocated in two Groups using closed envelope

Group (D+D) with desflurane and dexmedetomidine infusion

Group (S+D) with sevoflurane and dexmedetomidine infusion

After standard monitors applied After I.V. line was secured with 18/20 G intracath.Both inhalational anesthetics were subsequently titrated and adjusted to maintain a Minimum Alveolar Concentration (MAC) up to 1.5% for sevoflurane or 3% for desflurane. 0.4?g/kg/h dexmedetomidine infusion was applied both groups and when necessary it was titrated and the dose was increased up to 0.8 ?g/kg/h. Titration of dexmedetomidine was targeted to maintain MAP between 70 and 85 mmHg. Inhalation agents and dexmedetomidine infusion was continued until the end of surgery. Inj. Diclofenac sodium slow IV 1.5mg/kg was to be administered to all patients fifteen minutes before the end of the surgery. Fast Tract Criteria at the following 5th and 10th min was assessed in the OR and in 5th, 10th, 25th min in PACU. Patients were discharged from PACU after the FTC score is >13.
Conclusion: We conclude that desflurane / dexmedetomidine combination is superior to sevoflurane / dexmedetomidine in extubation time and in time FTC ? 13 in laparoscopic surgery.Intravenous use of dexmedetomidine is effective in controlling haemodynamic response t the time of creation of pneumoperitoneum and extubation, thus maintaining haemodynamic stability perioperatively in patients undergoing laparoscopic surgery

 

Keywords: Dexmedetomidine.

How to cite : Singh J, Vansola R, A comparative study of balanced anaesthesia with dexmedetomidine added desflurane or sevoflurane in laparoscopic surgery. Int J Aesthet Health Rejuvenation 2020;3(1):2-8

Copyright © 2020 by author(s) and Int J Aesthet Health Rejuvenation. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (CC-BY-NC 4.0) (creativecommons.org)