Rationale: Rise in BP is well known during laparoscopic cholecystectomy. Dexmedetomidine has been used as bolus followed by infusion for the same purpose, but it was associated with prolonged postoperative sedation. Present study was planned to assess the effect of single dose of dexmedetomidine without any infusion on haemodynamic parameters during laparoscopic cholecystectomy.

Methods: Forty patients (ASA I, 18-60 yrs M&F) undergoing elective laparoscopic cholecystectomy were selected. Anaesthesia was induced with inj morphine 0.1mg/kg, inj thiopentone 2.5%5-6mg/kg and inj vecuronium 0.1mg/kg followed by orotracheal intubation. Following induction of anaesthesia but before creation of pneumoperitoneum patients were randomly divided into two equal groups. Patients were given either 100ml NS 0.9% IV (group NS, n=20) or dexmedetomidine 1microgm/kg in 100ml NS (group DX, n=20) over a period of 10 minutes in double blind manner. Anaesthesia was maintained with oxygen, nitrous oxide and isoflurane through Bain’s circuit. IPPV was given to maintain EtCO2 between 35-40 mmHg.

Concentration of isoflurane was adjusted to maintain SBP ± 20% of base line value. Intraoperatively all patients were monitored for their HR, SBP, DBP, MAP, SPO2, EtCO2 and IAP with adequate fluid therapy. At the end of surgery neuromuscular blockade was reversed with inj neostigmine and glycopyrrolate.

Results: Both groups were comparable for their demographic profile and intraoperative heart rate (p>0.05); while systolic, diastolic and mean blood pressure remained significantly low in DX group during pneumoperitoneum (p<0.05). Requirement of isoflurane was also significantly low in DX group. Patients were sedated in both groups but score was higher in DX group upto 30min postoperatively.

Discussion: Dexmedetomidine centrally acting selective alpha2 agonist decreases blood pressure.

Conclusion: It was concluded that single IV dose of dexmedetomidine 1microgm/kg was sufficient to control BP during laparoscopic cholecystectomy without prolonged sedation