Key result
Premedication with dexmedetomidine significantly decreased the dose requirement of propofol by 43.01% and fentanyl by 33.58% compared to saline during elective general abdominal surgeries.
Why the study?
Does dexmedetomidine reduce perioperative pressor response and anesthetic dose requirements in patients undergoing elective general abdominal surgeries?
Observational (n=100)
No
Does dexmedetomidine reduce perioperative pressor response and anesthetic dose requirements in patients undergoing elective general abdominal surgeries?
Effect estimate: 43.01% reduction
Absolute Event Rate: 73.8% vs 129.5%
p-value: p=<0.001
Premedication with dexmedetomidine effectively attenuates perioperative pressor responses and significantly reduces the required doses of propofol and opioids during general anesthesia.
Hypothesis-generating for dexmedetomidine premedication; prospective trials needed before clinical adoption.
Background and Aims: Effective use of sedative-hypnotic and analgesic agents is an integral part of providing patient comfort and safety for patients during general anaesthesia. The present study was carried out to evaluate the effects of premedication with dexmedetomidine on perioperative haemodynamic and dose requirement of propofol and fentanyl during laryngoscopy and tracheal intubation. Methods: 100 patients belonging to ASA class I and ASA class II of either sex, in the age group of 20-55years were divided into two groups, Group 1 and Group 2 with 50 patients in each group. Group 1 received 100ml of Normal saline over a period of 10 minutes and 1g/kg of fentanyl 3 minutes before induction of general anaesthesia. Group 2 received 1g/kg of dexmedetomidine in 100 ml of normal saline over a period of 10 minutes and 1g/kg of fentanyl 3 minutes before induction of general anaesthesia. Results: The demographic profile was comparable. The pressor response to laryngoscopy, intubation, surgery and extubation were effectively decreased by dexmedetomidine, and were highly significant on comparison (P<0.001). The mean dose of fentanyl and propofol were also decreased significantly by the administration of dexmedetomidine. The total dose requirement of fentanyl and propofol was decreased by 33.58% and 43.01% in Group 2 as compared to Group 1 and the difference was statistically significant. Conclusions: Dexmedetomidine is an effective drug when used as an adjunct to general anaesthesia for attenuation of pressor response. It not only decreased the magnitude of stress response to intubation, surgery and extubation but also decreased the dose of propofol and opioids in achieving adequate anaesthesia and analgesia respectively.
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Nuzhat Ul Islam (2018) conducted an observational in Elective general abdominal surgeries (n=100). Dexmedetomidine vs. Normal saline was evaluated on Mean dose requirement of propofol (mg) (43.01% reduction, p=<0.001). Premedication with dexmedetomidine significantly decreased the dose requirement of propofol by 43.01% and fentanyl by 33.58% compared to saline during elective general abdominal surgeries.
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