Comparing the effect of dexmedetomidine with magnesium sulfate on hemodynamic changes in patients undergoing laparoscopic cholecystectomy

Abstract

Background: Evolution of laparoscopic surgery has been enormous help to both patient and surgeon, although incidence of pneumoperitoneum as consequence of laparoscopic surgery would cause hemodynamic instability. In this study, effect of dexmedetomidine and magnesium sulfate on hemodynamic status during laparoscopic cholecystectomy has been assessed. Materials and Methods: This study was a double-blind randomized clinical trial that was conducted on 61 patients. Patients were randomly assigned to 3 groups. Control group (C) saline infusion, dexmedetomidine group (D) 1 μg/kg and then 0.5 μg/kg/h of dexmedetomidine and magnesium sulfate group (M) 2 g and then 0.9 mg/kg/h of magnesium sulfate they received. Heart rate, systolic and diastolic blood pressure and mean arterial pressure were recorded at different times before and after taking the drug. Independent T-test, ANOVA, and chi-square were used for univariate analysis and ANOVA with repeated measures for multivariate analysis. Results: The distribution of patients in terms of demographic factors and surgery were the same in the three groups of the study (P<0.05). The lowest values of systolic, diastolic and mean arterial blood pressure in all three groups were seen at the time of the induction. No statistically significant difference was seen in most of the measurement times between the three intervention groups. Analysis of variance with repeated measurement did not show the interaction effect of time and group on blood pressure (P<0.05), but the effect of treatment groups on heart rate was significant (P=0.018). Conclusion: Dexmedetomidine infusion was generally not effective on the patient's blood pressure changes, but it was significantly more effective on heart rate changes than magnesium sulfate and the control group in almost the entire measurement process. Therefore, in terms of the heart rates, in the dexmethomidine group, the patients experienced more stable conditions.

Keywords

• dexmedetomidine
• magnesium sulfate
• laparoscopic cholecystectomy
• hemodynamic response