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Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia

BACKGROUND: Spinal anesthesia (SA) with sedation is considered to be an alternative to general anesthesia for laparoscopic cholecystectomy (LC) in high-risk patients. Ketamine in analgesic dose with propofol or dexmedetomidine infusion provides titratable sedation, hemodynamic stability, and minimum...

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Autores principales: Saini, Heena, Angral, Rajesh, Sharma, Shruti, Sharma, Raj Rishi, Kumar, Ravinder
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Wolters Kluwer - Medknow 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819412/
https://www.ncbi.nlm.nih.gov/pubmed/33487814
http://dx.doi.org/10.4103/aer.AER_64_20
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author Saini, Heena
Angral, Rajesh
Sharma, Shruti
Sharma, Raj Rishi
Kumar, Ravinder
author_facet Saini, Heena
Angral, Rajesh
Sharma, Shruti
Sharma, Raj Rishi
Kumar, Ravinder
author_sort Saini, Heena
collection PubMed
description BACKGROUND: Spinal anesthesia (SA) with sedation is considered to be an alternative to general anesthesia for laparoscopic cholecystectomy (LC) in high-risk patients. Ketamine in analgesic dose with propofol or dexmedetomidine infusion provides titratable sedation, hemodynamic stability, and minimum respiratory depression without psychomimetic effects. AIM: To compare the efficacy of ketamine–dexmedetomidine and ketamine-propofol combination in relation to sedation, analgesia, hemodynamic effects, and perioperative side effects. SETTINGS AND DESIGN: This was a prospective, randomized single-blind comparative study comprising 100 American Society of Anesthesiologists I, II, and III patients posted for LC. MATERIALS AND METHODS: Patients were randomized into two groups of 50 patients each. Group KP (ketamine + propofol) received intravenous (i.v.) bolus of injection ketamine 0.5 mg.kg (−1) and propofol infusion at 3 mg.kg (−1).h (−1). Group KD (ketamine + dexmedetomidine) received i.v. bolus of injection ketamine 0.5 mg.kg (−1) and dexmedetomidine infusion at 0.4 μg.kg (−1).h (−1). Parameters observed were vitals, perioperative side effects, time to first rescue analgesia, and return of consciousness. STATISTICAL ANALYSIS: Student's independent t-test was employed for comparing continuous variables. Chi-square test or Fisher's exact test, whichever appropriate, was applied for comparing categorical variables. RESULTS: Duration of analgesia was longer in KD Group (191.2 vs. 173.5 min), and time to regain consciousness was faster in KP Group (14.9 vs. 20.4 min). CONCLUSION: Both the techniques of sedation are feasible, safe, and comparable, except the duration of analgesia and time to regain consciousness which was longer in KD Group.
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spelling pubmed-78194122021-01-22 Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia Saini, Heena Angral, Rajesh Sharma, Shruti Sharma, Raj Rishi Kumar, Ravinder Anesth Essays Res Original Article BACKGROUND: Spinal anesthesia (SA) with sedation is considered to be an alternative to general anesthesia for laparoscopic cholecystectomy (LC) in high-risk patients. Ketamine in analgesic dose with propofol or dexmedetomidine infusion provides titratable sedation, hemodynamic stability, and minimum respiratory depression without psychomimetic effects. AIM: To compare the efficacy of ketamine–dexmedetomidine and ketamine-propofol combination in relation to sedation, analgesia, hemodynamic effects, and perioperative side effects. SETTINGS AND DESIGN: This was a prospective, randomized single-blind comparative study comprising 100 American Society of Anesthesiologists I, II, and III patients posted for LC. MATERIALS AND METHODS: Patients were randomized into two groups of 50 patients each. Group KP (ketamine + propofol) received intravenous (i.v.) bolus of injection ketamine 0.5 mg.kg (−1) and propofol infusion at 3 mg.kg (−1).h (−1). Group KD (ketamine + dexmedetomidine) received i.v. bolus of injection ketamine 0.5 mg.kg (−1) and dexmedetomidine infusion at 0.4 μg.kg (−1).h (−1). Parameters observed were vitals, perioperative side effects, time to first rescue analgesia, and return of consciousness. STATISTICAL ANALYSIS: Student's independent t-test was employed for comparing continuous variables. Chi-square test or Fisher's exact test, whichever appropriate, was applied for comparing categorical variables. RESULTS: Duration of analgesia was longer in KD Group (191.2 vs. 173.5 min), and time to regain consciousness was faster in KP Group (14.9 vs. 20.4 min). CONCLUSION: Both the techniques of sedation are feasible, safe, and comparable, except the duration of analgesia and time to regain consciousness which was longer in KD Group. Wolters Kluwer - Medknow 2020 2020-10-12 /pmc/articles/PMC7819412/ /pubmed/33487814 http://dx.doi.org/10.4103/aer.AER_64_20 Text en Copyright: © 2020 Anesthesia: Essays and Researches http://creativecommons.org/licenses/by-nc-sa/4.0 This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.
spellingShingle Original Article
Saini, Heena
Angral, Rajesh
Sharma, Shruti
Sharma, Raj Rishi
Kumar, Ravinder
Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia
title Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia
title_full Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia
title_fullStr Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia
title_full_unstemmed Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia
title_short Comparision of Dexmedetomidine and Propofol in Patients Undergoing Laparoscopic Cholecystectomy Under Spinal Anesthesia
title_sort comparision of dexmedetomidine and propofol in patients undergoing laparoscopic cholecystectomy under spinal anesthesia
topic Original Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7819412/
https://www.ncbi.nlm.nih.gov/pubmed/33487814
http://dx.doi.org/10.4103/aer.AER_64_20
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