Comparison of Opioid Versus Non-opioid-based Anesthesia Techniques for Hemodynamic and Neuro-endocrine Responses in Laparoscopic Surgeries

Abstract

ABSTRACT Objective: To analyze the effectiveness of dexmedetomidine and fentanyl pre-medication, followed by infusion in modulating hemodynamic and neuro-endocrine responses to laryngoscopy and pneumoperitoneum during laparoscopic surgery. Methods: Forty adult patients were randomized into two groups. Before induction, group dexmedetomidine (group D) were given dexmedetomidine at 0.5 μgm/kg IV as loading over 10 min and infusion at the rate of 0.2 mcg/kg/hour during the surgical procedure. Group fentanyl (group F) were given 0.5 mcg/kg as loading over 10 min and infusion at the rate of 0.2 mcg/kg/hour during the surgical procedure. Hemodynamic parameters and blood glucose levels were pre-operatively monitored. Results: No significant differences were observed in the demographic profiles. There was a discernible difference in the heart rate compared to the pre-operative values in both groups. The systolic blood pressure was significantly lower in group D than in group F. There were no significant changes in the blood glucose levels during the intra-operative period, and the blood glucose levels remained low after extubation in group D (P = 0.0001). Conclusion: Dexmedetomidine causes greater attrition of the hemodynamic response to intubation and pneumoperitoneum during the peri-operative period and modulates the neuro-endocrine stress response, resulting in better hemodynamic stability.