A Prospective Study on the Haemodynamic Stress Responses to Surgeries and the Intra-Operative and Post-Operative Effects of Dexmedetomidine

Background The surgical stress response triggers neuroendocrine and hemodynamic variations that can compromise patient outcomes. Dexmedetomidine, an alpha-2 adrenoceptor agonist, offers sedation, analgesia, and hemodynamic stability without respiratory depression. Methods This prospective study was carried out at Deen Dayal Upadhyay Hospital over six months and included 100 adult patients (ASA I/II) undergoing elective surgeries lasting over one hour. Patients were categorized into two groups: one receiving dexmedetomidine and the other a saline placebo. Hemodynamic parameters, anesthetic and analgesic requirements, and postoperative pain scores were monitored. Results Dexmedetomidine significantly stabilized heart rate, with a reduction from 78.0 ± 4.1 bpm in the placebo group to 69.0 ± 3.5 bpm before induction (p = 0.0001). Mean arterial pressure (MAP) was lower in the dexmedetomidine group after intubation (96.5 ± 2.0 mm Hg vs. 105.4 ± 3.2 mm Hg, p = 0.0001) and during surgery, with values of 84.3 ± 2.2 mm Hg compared to 89.8 ± 2.5 mm Hg (p = 0.0001). Additionally, patients in the dexmedetomidine group required significantly less propofol (93.5 ± 3.1 mg vs. 110.8 ± 7.5 mg, p = 0.0001) and reported lower postoperative pain scores at 60 minutes (0.5 ± 0.3 vs. 1.2 ± 0.4, p = 0.0001). Conclusion Dexmedetomidine is effective as an anesthetic adjunct, enhancing hemodynamic stability and postoperative analgesia while reducing anesthetic and opioid requirements. Recommendation We recommend researchers to do additional studies with a substantial sample size, incorporating invasive blood pressure measurement and multicenter randomized controlled trials.