Serial Blood Glucose Level Estimation to Assess the Attenuation of Metabolic and Hemodynamic Stress Responses with Dexmedetomidine Infusion during Laparoscopic Surgery - A Randomized Control Study:

Ivesh Singh; Kumkum Gupta; Prashant K Gupta; Manish Jain; Bhawana Rastogi; Manoranjan Kumar Bansal

doi:10.21276/aan.2019.4.1.19

Ivesh Singh Assistant Professor, Department of Anaesthesiology and Critical care, Subharti Medical College, Swami Vivekanand Subharti University, NH-58 Bye Pass Road, Meerut-UP, India.
Kumkum Gupta Professor, Department of Anaesthesiology and Critical care, Subharti Medical College, Swami Vivekanand Subharti University, NH-58 Bye Pass Road, Meerut-UP, India.
Prashant K Gupta Director & Professor, Department of Radio diagnosis and Imaging, Subharti Medical College, Swami Vivekanand Subharti University, NH-58 Bye Pass Road, Meerut-UP, India.
Manish Jain Professor, Department of Anaesthesiology and Critical care, Subharti Medical College, Swami Vivekanand Subharti University, NH-58 Bye Pass Road, Meerut-UP, India.
Bhawana Rastogi Professor, Department of Anaesthesiology and Critical care, Subharti Medical College, Swami Vivekanand Subharti University, NH-58 Bye Pass Road, Meerut-UP, India.
Manoranjan Kumar Bansal Assistant Professor. Department of Anaesthesiology and Critical care, Subharti Medical College, Swami Vivekanand Subharti University, NH-58 Bye Pass Road, Meerut-UP, India.

DOI: https://doi.org/10.21276/aan.2019.4.1.19

Keywords: Dexmedetomidine, Laparoscopic surgery, Metabolic and Hemodynamic stress response, Pneumoperitoneum

Abstract

Background: Laparoscopic surgery under general anaesthesia activates the neurohumoral stress responses thereby causing release of significant amount of catecholamines into the tissue. We hypothesized that intraoperative dexmedetomidine infusion would attenuate the metabolic and hemodynamic changes during laparoscopic surgery which could be assessed by estimating the serial blood sugar level. Subjects and Methods: Sixty adult consenting patients undergoing laparoscopic surgery were enrolled. Patients were randomized into two equal groups of 30 patients each. Patients of Group D received loading dose of dexmedetomidine 1g/kg over 10 min, followed by dexmedetomidine infusion at rate of 0.5g/kg/h while patients of Group C received equal volume of normal saline. Primary end points were changes in heart rate, blood pressure, electrocardiogram, emergence time and serial blood glucose levels. Any adverse effects related to dexmedetomidine or anesthetic technique, were noted as secondary outcome. Results: Patients of Group D showed comparatively lower intraoperative heart rate and mean arterial blood pressure with no significant changes in cardiac rhythm. The blood glucose concentration showed 20% increase after surgery in patients of Group D versus 35% increase in patients of Group C, with statistically significant difference. The emergence time in patients of Group C was significantly lower when compared to patients of Group D. Conclusion: Dexmedetomidine infusion has effectively attenuated the metabolic and hemodynamic changes during laparoscopic surgery with inherent advantages of analgesia, sedation and anaesthetic sparing effects.

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