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首页> 外文期刊>Indian journal of Anaesthesia >Effects of low dose dexmedetomidine infusion on haemodynamic stress response, sedation and post-operative analgesia requirement in patients undergoing laparoscopic cholecystectomy
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Effects of low dose dexmedetomidine infusion on haemodynamic stress response, sedation and post-operative analgesia requirement in patients undergoing laparoscopic cholecystectomy

机译：小剂量右美托咪定输注对腹腔镜胆囊切除术患者血流动力学应激反应，镇静作用和术后镇痛的影响

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Background and Aim:Dexmedetomidine is a α2 agonist with sedative, sympatholytic and analgesic properties and hence, it can be a very useful adjuvant in anaesthesia as stress response buster, sedative and analgesic. We aimed primarily to evaluate the effects of low dose dexmedetomidine infusion on haemodynamic response to critical incidences such as laryngoscopy, endotracheal intubation, creation of pneumoperitoneum and extubation in patients undergoing laparoscopic cholecystectomy. The secondary aims were to observe the effects on extubation time, sedation levels, post-operative analgesia requirements and occurrence of adverse effects.Methods:Sixty patients of American Society of Anaesthesiologists(ASA) physical grades I and II undergoing laparoscopic cholecystectomy were randomly allocated into three groups of 20 patients each. Group NS patients received normal saline, Group Dex 0.2 and Group Dex 0.4 patients received dexmedetomidine infusion at 0.2 mcg/kg/h and 0.4 mcg/kg/h respectively, starting 15 min before induction and continued till end of surgery. Parameters noted were pulse rate, mean arterial pressure, oxygen saturation, post-operative sedation and analgesia requirements. SPSS 15.0 version software was used for statistical analysis. ANOVA test for continuous variables, post-hoc test for intergroup comparison, and Chi-square test for discrete values were applied.Results:In Group NS significant haemodynamic stress response was seen following laryngoscopy, tracheal intubation, creation of pneumoperitoneum and extubation. In dexmedetomidine groups, the haemodynamic response was significantly attenuated. The results, however, were statistically better in Dex 0.4 group compared with Dex 0.2 group. Post-operative 24 hour analgesic requirements were much less in dexmedetomidine groups. No significant side effects were noted.Conclusion:Low dose dexmedetomidine infusion in the dose of 0.4 mcg/kg/h effectively attenuates haemodynamic stress response during laparoscopic surgery with reduction in post-operative analgesic requirements.
机译：背景与目的：右美托咪定是一种具有镇静，交感和镇痛作用的α2激动剂，因此在麻醉中作为缓解压力的镇静剂，镇静剂和镇痛药非常有用。我们的主要目的是评估低剂量右美托咪定输注对腹腔镜胆囊切除术患者对喉镜，气管内插管，气腹创建和拔管等关键事件的血流动力学反应的影响。次要目的是观察对拔管时间，镇静水平，术后镇痛要求和不良反应发生的影响。方法：将60例美国麻醉医师协会（ASA）的I级和II级物理患者接受腹腔镜胆囊切除术三组，每组20名患者。 NS组患者接受生理盐水，Dex 0.2组和Dex 0.4组患者分别于诱导前15分钟开始以0.2 mcg / kg / h和0.4 mcg / kg / h的右美托咪定输注，并一直持续到手术结束。记录的参数为脉搏率，平均动脉压，血氧饱和度，术后镇静和镇痛要求。使用SPSS 15.0版本软件进行统计分析。结果：在NS组中，在喉镜，气管插管，气腹和拔管后观察到明显的血流动力学应激反应。在右美托咪定组中，血流动力学反应明显减弱。然而，与Dex 0.2组相比，Dex 0.4组的结果在统计学上更好。右美托咪定组的术后24小时镇痛需要量要少得多。结论：结论：低剂量右美托咪定输注剂量为0.4 mcg / kg / h可有效减轻腹腔镜手术过程中的血流动力学应激反应，并减少术后止痛要求。

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