Abstract No.: ABS1979: Effects of dexmedetomidine versus fentanyl combined with target controlled infusion of propofol for laproscopic surgery under general anaesthesia

BACKGROUND & AIMS: 1.The primary objective of the present study wasto compare anaesthetic efficacy of dexmedetomidine versus fentanyl in terms of : Perioperative hemodynamics, Propofol consumption, Requirment of Rescue analgesia and also to compare postoperative analgesia and sedation between the two while the secondary objective was to assess any undesirable side effects if any 2. METHODS: The present study was a prospective, randomized, double blind study conducted on 60 patients of American Society of Anesthesiologists ASA I&II aged between 20-60 years undergoing elective laproscopic surgeries. Patients were divided in two groups. GroupD received Dexmedetomidine 1mcg/kg loading dose over 10 min, followed by 0.5 µg/kg/hr continous infusion &GroupF received fentanyl 2 µg/kg bolus followed by 0.5 µg/kg/hr by continous infusion. Target controlled infusion (TCI) Propofol infusion was given to achieve target site concentration of 3-4 µg/kg in both groups. Heart rate (HR), mean arterial pressure (MAP),systolic pressure, diastolic pressure, percentage saturation of oxygen (Spo2), bispectral index monitoring (BIS) were recorded at induction,intubation, at pneumoperitoneum, 5 min, 15 min, 30 min, 45 min, 60 min, 120 min, 180 min & at extubation.Adverse haemodynamic events were noted. RESULTS: Group D showed significant fall in HR, BP whereas it remained constantly high in Group F. Total mean requirement of propofol, in Group D patients was found to be 57.99% lower than GroupF. Requirement of rescue analgesia in form of opioid was significantly less in Group D 18% as compared to 30% in Group F. Post-operative analgesia requirement was earlier in group F. Sedation scores were higher in group D at all time points. Patients had bradycardia and hypotension in Group D. Postoperative nausea vomiting (PONV) was 3 times lower in Group D. CONCLUSION: Dexmedetomidine is better adjuvant compared to fentanyl when combined with target-controlled infusion of propofol. Iteffectively blunts various stress responses during surgery and maintains hemodynamic stability,reducespropofol requirements, provides better analgesia with few side effects.