Comparison of postoperative analgesia and sedation responses of intravenous dexmedetomidine and esmolol during laparoscopic cholecystectomy

Azka Zuberi; Tahir Ahamad Masoodi; Bhawana Rastogi; Rajni Gupta; Anita Malik; Raza Farooqui

doi:10.18203/2320-6012.ijrms20191658

Authors

Azka Zuberi Department of Anaesthesiology and Critical Care, Subharti Medical College, Meerut, Uttar Pradesh, India
Tahir Ahamad Masoodi Department of Anaesthesiology and Critical Care, Subharti Medical College, Meerut, Uttar Pradesh, India
Bhawana Rastogi Department of Anaesthesiology and Critical Care, Subharti Medical College, Meerut, Uttar Pradesh, India
Rajni Gupta Department of Anaesthesiology and Critical Care, KNG George Medical University, Lucknow, Uttar Pradesh, India
Anita Malik Department of Anaesthesiology and Critical Care, KNG George Medical University, Lucknow, Uttar Pradesh, India
Raza Farooqui Department of General Surgery, Muzaffarnagar Medical College, Muzaffarnagar, Uttar Pradesh, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20191658

Keywords:

Dexmedetomidine, Esmolol, Laparoscopic cholecystectomy, Postoperative pain, Sedation

Abstract

Background: Although, the concept of laparoscopic surgeries has revolutionised the surgical practice and has markedly reduced the incidence of complications especially postoperative pain. However, the menace of postoperative pain still remains challenge, especially in first 24 hours. The present study was conducted to comparatively analyse the postoperative pain and sedation using intravenous dexmedetomidine and intravenous esmolol during laparoscopic cholecystectomy.

Methods: Study was conducted on 90 adult patients aged 18-60 years of ASA grade I or II of both genders, scheduled for laparoscopic cholecystectomy under general anaesthesia. Patients were randomized into three groups of 30 patients each. Patients of group A received esmolol infusion (loading: 1 mg/kg and maintenance: 5-15 µg/kg/min), patients of group B received dexmedetomidine infusion (loading: 0.7 µg/kg and maintenance: 0.4 µg/kg/hour) and group C (control group) received normal saline infusion. During the post-operative period of 24 hours, patient were monitored for sedation using Ramsay sedation score like pain, using visual analogue score (VAS), incidence of post-operative nausea and vomiting and use of any drug for pain, vomiting and any other side effect.

Results: Frequency of pain was highest in group C at all post periods, followed by group A and was least in group B. The mean sedation score of group B was comparatively higher as compared to both group C and group A.

Conclusions: The inference authors drew was that dexmedetomidine is better analgesic with aurousable sedation.

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References

Cunningham AJ, Brull SJ. Laparoscopic cholecystectomy: anesthetic implications. Anesthesia and analgesia. 1993;76(5):1120-33.

Sharma R, Gupta R, Choudhary R, Bajwa SJ. Postoperative analgesia with intravenous paracetamol and Dexmedetomidine in laparoscopic cholecystectomy surgeries: a prospective randomized comparative study. Int J App Basic Med Res. 2017;7(4):218.

Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: a review of clinical applications. Current Opinion Anesthesiol. 2008;21(4):457-61.

Chia YY, Chan MH, Ko NH, Liu K. Role of β-blockade in anaesthesia and postoperative pain management after hysterectomy. Brit J Anaes. 2004;93(6):799-805.

White PF, Wang B, Tang J, Wender RH, Naruse R, Sloninsky A. The effect of intraoperative use of esmolol and nicardipine on recovery after ambulatory surgery. Anes Analgesia. 2003;97(6):1633-8.

Málek J, Marecek F, Hess L, Kurzová A, Ocadlík M, Votava M. A combination of dexmedetomidine with ketamine and opioids results in significant inhibition of hemodynamic changes associated with laparoscopic cholecystectomy and in prolongation of postoperative analgesia. Perspectives Surg Month Czechoslovak Surg Soc. 2010;89(5):275-81.

Tufanogullari B, White PF, Peixoto MP, Kianpour D, Lacour T, Griffin J, et al. Dexmedetomidine infusion during laparoscopic bariatric surgery: the effect on recovery outcome variables. Anes Analgesia. 2008;106(6):1741-8.

Dholakia C, Beverstein G, Garren M, Nemergut C, Boncyk J, Gould JC. The impact of perioperative dexmedetomidine infusion on postoperative narcotic use and duration of stay after laparoscopic bariatric surgery. J Gastrointes Surg. 2007;11(11):1556-9.

Bakhamees HS, El-Halafawy YM, El-Kerdawy HM, Gouda NM, Altemyatt SU. Effects of dexmedetomidine in morbidly obese patients undergoing laparoscopic gastric bypass. Middle East J Anesthesiol. 2007;19(3):537-1.

López-Álvarez S, Mayo-Moldes M, Zaballos M, Iglesias BG, Blanco-Dávila R. Esmolol versus ketamine-remifentanil combination for early postoperative analgesia after laparoscopic cholecystectomy: a randomized controlled trial. Can J Anes J. 2012;59(5):442-8.

Lee SJ, Lee JN. The effect of perioperative esmolol infusion on the postoperative nausea, vomiting and pain after laparoscopic appendectomy. Korean J Anesthesiol. 2010;59(3):179.

Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, and analgesic properties of small-dose dexmedetomidine infusions. Anes Analgesia. 2000;90(3):699-705.