ABSTRACT : Dexmeditomidine(Dex), an alpha2 agonist, when used as adjuvant to general anesthesia attenuates stress response to various noxious stimuli, maintains perioperative hemodynamic stability and provides sedation without respiratory depression post operatively during laparoscopic surgeries. We designed this prospective, randomized, double blind, and placebo-controlled dose-ranging study to evaluate the effect of Dex on perioperative hemodynamic stability, analgesic requirement and the time to recovery after laparoscopic surgeries.

METHODS : After ethical committee approval and informed consent, sixty patients were randomly assigned to 3 groups, Group 1 –control group received placebo saline infusion, Group 2-Dex 0.2 µ group received dexmeditomidine 0.2µ/kg/hr IV infusion, Group 3-Dex 0.4 µ group received dexmeditomidine 0.4 µ/kg/hr IV infusion. Dex infusion was started 5 min before induction of anaesthesia & fentanyl used as narcotics and isoflurane for maintenance of anaesthesia. Mean arterial blood pressure values maintained ±20% pre induction values by varying inspired isoflurane concentration. Parameters like perioperative hemodynamic variables at various intervals, time to recovery, post operative sedation score and time to discharge from PACU recorded.

RESULTS :Dex infusion, 0.2, and 0.4µ/kg/hr , reduced the requirement of average inspired isoflurane concentration significantly. There was no change in recovery from anesthesia in both Dex& Control group. In Dex group hemodynamic parameters are well maintained (±20 % of baseline) with less inspired concentration of isoflurane compared to control group which needed more isoflurane concentration or rescue esmolol infusion. The length of the PACU stay & administration of rescue tramodol is significantly less in Dex groups.

CONCLUSIONS : Adjuvant use of intra operative Dex infusion of both 0.2& 0.4µ/kg/hr attenuated intra operative sympathetic stimulation & reduced the analgesic requirement, antiemetic therapy and the length of PACU stay.