A study to compare the efficacy of dexmedetomidine with esmolol on hemodynamic response during laparoscopic cholecystectomy

Introduction: Laparoscopic surgery is a routinely performed surgery and it is desirable to have stable intra-operative hemodynamic states by avoiding hypertension and tachycardia. Various drugs have been employed to attenuate this hemodynamic response. No single drug is satisfactory. Thus there is a need to find a simple efficient and reliably consistent method. Aim: The present study was undertaken to evaluate the comparison of Dexmedetomidine and Esmolol on perioperative hemodynamic response during laparoscopic cholecystectomy. Materials and methods: Prospective, randomized, controlled, single blinded trial comparing dexmedetomidine (alpha 2- agonist) and esmolol (beta 1-antagonist) done by allocating into two groups. It was conducted in 60 patients of both sex, belong to ASA I and ASA II of age group 20-60 years admitted for laparoscopic surgery from 2016-2017. They were randomly divided into two groups of 30 patients each. The Heart rate (HR), Systolic blood pressure (SBP), Diastolic blood pressure (DBP), Mean arterial pressure (MAP) were recorded prior to induction, after the induction, after the intubation, 15 min, 30 min, 45 min, 60 min after creation of pneumoperitoneum, post pneumoperitoneum, after extubation. Results: Heart rate and systolic blood pressure were significantly lower in Group A after induction, after intubation, and maintained throughout intraoperative and postoperative period compared to Group B. Diastolic blood pressure were significantly lower in Group A after intubation, and maintained throughout intraoperative period and at extubation compared to Group B. Diastolic blood pressure was not significant after induction, at postoperative period. Mean blood pressure were significantly lower in Group A after induction, after intubation, and maintained throughout intraoperative period and at extubation compared to Group B. Mean blood pressure were not significant at postoperative period. Conclusion: Dexmedetomidine is more effective agent than esmolol in maintaining stable hemodynamics during and after pneumoperitoneum in laparoscopic cholecystectomy.