The Effect of Dexmedetomidine on Haemodynamic Changes, Extubation Time and Sedation during Laparoscopic Hysterectomy

Background and Aim Suppression of deleterious effect of pneumoperitoneum is a very important goal of laparoscopic surgeries. Dexmedetomidine is a highly selective α2adrenoreceptor agonist that causes centrally mediated reduction of sympathetic nervous system activity and lead to sedation and analgesia. The aim of our study was to evaluate the effect of dexmedetomidine on haemodynamic response of intraoperative events like laryngoscopy, endotracheal intubation, pneumoperitoneum and extubation time, and sedation during and after laproscopic hysterectomy. Methods A prospective, randomised and double blind study was done on 50 female patients, undergoing laparoscopic total hysterectomy. All patients were randomly allocated into two groups; group D (dexmedetomidine) and group C (normal saline). Group D received inj dexmedetomidine 1 μg/kg, diluted in 50 ml of normal saline over 15 min of duration and 0.4 μg/kg/h infusion was started till the pneumoperitoneum continues. Group C patients receive normal saline infusion. Parameter recorded was heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean blood pressure (MAP), SPO2 and ETCO2. Assessment of sedation was done at extubation than every 15 min for 2 h by Ramsay sedation score (RSS). Results Among haemodynamic profile, mean arterial pressure and HR after drug administration were significantly lower in perioperative period, particularly at intubation and extubation time in dexmedetomidine (group D) as compared with controls (group C). The extubation time was significantly lower in the dexmedetomidine groups than in the control group. No significant change was seen in the sedation score in both the groups. Conclusion Dexmedetomidine use during laparoscopic hysterectomy leads to attenuation of hemodynamic response to pneumoperitonium and decrease in extubation time with no change in sedation level of the patients.