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Comparative Studies | Anaesthesiology | India | Volume 14 Issue 3, March 2025 | Popularity: 5.5 / 10
Dexmedetomidine vs Magnesium Sulphate for Optimizing Hemodynamic Stability in Laparoscopic Surgery: A Prospective Randomized Double-Blind Controlled Study
Dr. Ithi Noel Isaiah, Dr. Dhruti Prasad Parida
Abstract: Background: Laparoscopic surgery has become the preferred surgical approach due to its benefits, including reduced morbidity, mortality, and hospital stay. However, the hemodynamic changes associated with CO2 pneumoperitoneum, including increased mean arterial pressure, systemic vascular resistance, and myocardial oxygen demand, pose challenges for anaesthesiologists. Various pharmacological agents were used to mitigate these responses. This study compared the efficacy of Dexmedetomidine and Magnesium Sulphate in attenuating hemodynamic fluctuations during laparoscopic surgery under general anaesthesia. Aims: To evaluate and compare the efficacy of intravenous Dexmedetomidine and Magnesium Sulphate infusion in maintaining hemodynamic stability during laparoscopic surgery and to assess any adverse effects of these drugs. Study Design: A prospective randomized double-blind controlled study. Material and Methods: The study was conducted at Hi-Tech Medical College & Hospital, Bhubaneswar, from March 2023 to February 2025. The study included 135 ASA I and II patients aged 18-60 years, scheduled for elective laparoscopic surgery. Patients were randomly divided into three groups: Group C: Received 0.9% Normal Saline (control group). Group D: Received Dexmedetomidine 1 mcg/kg over 10 minutes, followed by an infusion of 0.5 mcg/kg/hour. Group M: Received Magnesium Sulphate 30 mg/kg over 10 minutes, followed by an infusion of 10 mg/kg/hour. Hemodynamic parameters, including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP), were recorded at baseline, before and after intubation, and at 5, 10, 20, 30, and 40 minutes of pneumoperitoneum. Adverse drug reactions, such as hypotension, bradycardia, and hypoxia were also monitored. Results and Discussion: This study statistically confirmed that Dexmedetomidine was more effective than Magnesium Sulphate in controlling hemodynamic responses during laparoscopic surgery under general anaesthesia. Patients in the Dexmedetomidine group exhibited significantly lower HR, SBP, DBP, and MAP at all measured intervals (p < 0.05), ensuring greater cardiovascular stability. Although mild bradycardia and hypotension were observed, they were manageable and did not compromise patient safety. Given these findings, Dexmedetomidine emerges as a superior agent for attenuating the cardiovascular effects of pneumoperitoneum, supporting its preferential use in laparoscopic procedures. Conclusion: This study provides insights into the relative efficacy of Dexmedetomidine and Magnesium Sulphate in managing hemodynamic responses during laparoscopic surgery. The findings will aid anaesthesiologists in optimizing patient safety and perioperative management during laparoscopic procedures.
Keywords: Dexmedetomidine, Magnesium Sulphate, Laparoscopic Surgery, Hemodynamic Stability, General Anaesthesia, Pneumoperitoneum
Edition: Volume 14 Issue 3, March 2025
Pages: 471 - 474
DOI: https://www.doi.org/10.21275/SR25310164839
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