Volume : 7, Issue : 4, April - 2018

A COMPARATVE CLINICAL STUDY ON THE EFFECTS OF DEXMEDETOMIDINE AND NALBUPHINE ON HEMODYNAMICS OF PATIENTS UNDERGOING LAPAROSCOPIC CHOLECYSTECTOMY

Anivesh Mishra, Ladhu Lakra, Usha Suwalka, Boniface Hembrom, Ekramul Haque

Abstract :

<p class="MsoNormal" style="text-align:justify"><span style="font-size:10.0pt;&#10;line-height:115%">INTRODUCTION : Owing to the hemodynamic response to tracheal intubation and pneumoperitoneum ,laparoscopic surgery is not devoid of risks, many drugs have been used to blunt the pressor response to achieve a stable hemodynamics. <o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify"><span style="font-size:10.0pt;&#10;line-height:115%">AIMS<span style="mso-spacerun:yes">&nbsp; </span>AND OBJECTIVES : This prospective, randomized study was designed to compare the effects of dexmedetomidine and nalbuphine on orotracheal intubation,hemodynamic responses and postoperative respiratory depression during laparoscopic cholecystectomy . Any other adverse effect of both the drugs was also studied.</span><span style="font-size:10.0pt;line-height:115%;font-family:&quot;Bookman Old Style&quot;,&quot;serif&quot;;&#10;mso-bidi-font-family:Arial"><o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify"><span style="font-size:10.0pt;&#10;line-height:115%;font-family:&quot;Bookman Old Style&quot;,&quot;serif&quot;;mso-bidi-font-family:&#10;Arial">MATERIAL AND METHODS : <span style="mso-spacerun:yes">&nbsp;</span>A total of 100 patients of 18-60 years, ASA grade I/II<span style="mso-spacerun:yes">&nbsp; </span>of either sex for elective laparoscopic cholecystectomy under general anaesthesia were included. The patients were randomly divided into two groups of 50 patients each. Group I received IV dexmedetomidine 1.0 ug/kg and Group II received IV nalbuphine 0.2 mg/kg over 10 mins diluted in 20ml normal saline. Hemodynamic parameters were recorded.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify"><span style="font-size:10.0pt;&#10;line-height:115%;font-family:&quot;Bookman Old Style&quot;,&quot;serif&quot;;mso-bidi-font-family:&#10;Arial">RESULTS : Control of HR, MAP in Group I was better than in Group II during laryngoscopy, intubation and PNP. Respiratory depression was not seen in either group. No patients had marked hypotension (MAP &lt; 60 mmHg) or adycardia ( HR &lt; 45 / min) in both groups but there were significant decrease in HR and MAP between the two groups during induction and after giving test drug.<o:p></o:p></span></p> <p class="MsoNormal" style="text-align:justify"><span style="font-size:10.0pt;&#10;line-height:115%;font-family:&quot;Bookman Old Style&quot;,&quot;serif&quot;;mso-bidi-font-family:&#10;Arial">CONCLUSION : The present study demonstrates the benefits of dexmedetomidine over nalbuphine in hemodynamic stability and analgesic quality in laparoscopic cholecystectomy. Thus establishing its utility for attenuation of pressor response.<o:p></o:p></span></p>