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Indian Journal of Clinical Anaesthesia


DEXMEDETOMIDINE REDUCES HAEMODYNAMIC VARIATION IN PAEDIATRIC PATIENTS DURING SURGERY


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Author Details: Badri Prasad Das, Ram Badan Singh, Rajiv Kumar Dubey, Yashpal Singh

Volume : 2

Issue : 1

Online ISSN : 2394-4994

Print ISSN : 2394-4781

Article First Page : 6

Article End Page : 14


Abstract

Background: Anaesthesia and surgery (thoracic and upper abdominal) are very stressful and painful and pain if not relived adequately it may lead to hemodynamic instability with respiratory compromise and increased complications in intra-operative and Post-operative period. The common agents available for sedation and analgesia includes opiates and benzodiazepines. Use of these agents have side effects, including respiratory and cardiovascular depression. Dexmedetomidine HCl, a highly potent α2-adrenergic agonist, have sedative, analgesic, hypnotic and anxiolytic effects without causing respiratory depression. Objective: The objective of this study is to find out safe and effective adjuvant of analgesic and sedative drug which can reduce stress of anesthesia and surgery and provide stable hemodynamics in intra operative period with rapid recovery from anesthesia.
Material and Methods: After ethical clearance and informed consent 120 eligible paediatric patients aged 2-10 years, of either sex, ASA physical status I and II scheduled for thoracic and upper abdominal surgeries were allocated randomly into 2 groups (DEX group and NS group) each containing 60 patients. DEX group received Dexmedetomidine 1mcg/kg (loading) (made to 20ml) slow IV injection over 20minutes, before inducing anaesthesia, followed by 0.5mcg/kg/hour (maintenance) peri & post-operatively over 6hours through infusion pump. NS Group received only normal saline 20ml slow IV injection over 20minutes, before inducing anaesthesia and continued infusion in same way as DEX group. General anaesthesia was induced using a standard dosage protocol. Hemodynamic parameters monitored and recorded at frequent interval. Statistical analysis was done and data were analysed.
Results: Stress induced Hemodynamic response during laryngoscopy, intubation, surgery and extubation was significantly less in Dex group patients with lesser halothane consumption and rescue analgesic requirement ( p<0.05) in intra operative period.
Conclusion: Use of IV Dexmedetomidine peri-operatively, significantly decreases haemodynamic response of stress related to anaesthesia and surgery. It also decreases sedative and analgesic requirements with good pain relief and stable haemodynamics with lower post- operative complications.

Key Words: Dexmedetomidine, Anesthesia, Surgery, Haemodynamic response.