Comparison of Intranasal Dexmedetomidine with Intravenous Dexmedetomidine as Premedication in Patients undergoing Laparoscopic Surgeries under General Anaesthesia: A Randomised Controlled Trial
Introduction: The sympathetic stress response due to pneumoperitoneum during laparoscopic surgeries necessitates a balanced anaesthesia technique. Dexmedetomidine (DEX) has emerged as a promising option. While intravenous (i.v.) DEX is well established in attenuating the haemodynamic stress response...
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| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2025-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/21104/76448_CE[Ra1]_F(SHU)_QC(PS_IS)_PF1(AG_KR)_PFA(IS)_PN(IS).pdf |
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| Summary: | Introduction: The sympathetic stress response due to pneumoperitoneum during laparoscopic surgeries necessitates a balanced anaesthesia technique. Dexmedetomidine (DEX) has emerged as a promising option. While intravenous (i.v.) DEX is well established in attenuating the haemodynamic stress response to pneumoperitoneum, the Intranasal (IN) route remains underexplored for this purpose.
Aim: To compare the efficacy and safety of IN and i.v. DEX in attenuating the haemodynamic stress response to pneumoperitoneum.
Materials and Methods: In this randomised triple-blind controlled trial which was conducted at Shri Guru Ram Rai Institute of Medical and Health Sciences, Dehradun, Uttarakhand, India. A total of 75 adults classified as American Society of Anaesthesiologists (ASA) physical status I or II, scheduled for elective laparoscopic surgery, were randomly allocated to one of three groups (25 in each group): control, IN DEX (IN group), and i.v. DEX (i.v. group). DEX was administered at a dose of 1 μg/kg via the IN or i.v. route before induction. Heart Rate (HR) and Mean Arterial Pressure (MAP) were monitored until 10 minutes postextubation at appropriate time intervals, along with preoperative sedation scores and any side-effects. All statistical calculations were performed using Statistical Package for the Social Sciences (SPSS) 21.0 version (SPSS Inc., Chicago, IL, USA) statistical program for Microsoft Windows.
Results: Patients were comparable with respect to age (p-value=0.769), gender (p-value=0.321), and weight (p-value=0.672). HR and MAP were significantly lower in the IN and i.v. groups compared to the control group during pneumoperitoneum, but were comparable between the IN and i.v. groups. Both of these groups had better sedation scores compared to the control group. None of the groups experienced any significant side-effects.
Conclusion: Both IN and i.v. DEX have similar efficacy and safety in alleviating the haemodynamic stress response to pneumoperitoneum. Side-effects such as bradycardia, hypotension, nausea, vomiting and shivering were comparable among the three groups. Both IN and i.v. DEX provided comparably satisfactory preoperative sedation, which was significantly better than that of the control group. |
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| ISSN: | 2249-782X 0973-709X |