Outcome of intraoperative dexmedetomidine infusion in laparoscopic cholecystectomy

Background and Aims Laparoscopic cholecystectomy (LC) is favored by less postoperative pain compared with the open approach; nevertheless, pain is still a frequent complaint. Dexmedetomidine is a centrally acting alpha 2 agonist that has sedative, sympatholytic, and analgesic properties. We aimed primarily to study the effect of different doses of dexmedetomidine on the quality of anesthesia in the patients undergoing LC. The secondary aims were to detect the implications of these different doses on the postoperative outcome (postoperative pain, nausea, and vomiting. Methods Sixty patients of the American Society of Anesthesiologists (ASA) physical grades I and II scheduled for elective LC were randomly divided into three equal groups. Group Dex 0.2, Group Dex 0.4, and Group Dex 0.6 (patients received dexmedetomidine infusion at 0.2 mcg/kg/h, 0.4 mcg/kg/h, and 0.6 mcg/kg/h, respectively) 15 min before induction and throughout the surgical procedure. Hemodynamic parameters, spontaneous respiratory recovery time, extubation time, incidence of cough, postoperative pain, and postoperative nausea and vomiting (PONV) were recorded. Results Significantly attenuated hemodynamic stress response was observed in Dex 0.4 and Dex 0.6 groups. The incidence of cough, PONV, was significantly less and postoperative analgesic requirements were fewer in Dex 0.6 group compared to the other two groups. Nevertheless, the time of spontaneous respiratory recovery and extubation in Dex 0.6 group was insignificantly longer compared to the other two groups. Conclusion Intravenous infusion of 0.6 mu g/kg/h dexmedetomidine before induction can attenuate hemodynamic stress response, reduce cough incidence, PONV, and postoperative analgesic requirements in patients undergoing LC without significant prolongation of spontaneous respiratory recovery time.