Comparative Evaluation of Intravenous Labetalol Dexmedetomidine and Lignocaine for Attenuation of Hemodynamic Response to Pneumoperitoneum A Randomized Controlled Study
Keywords:
Dexmedetomidine Labetalol, Lignocaine, Hemodynamic response, Laparoscopic cholecystectomy, Pneumoperitoneum, General anaesthesiaAbstract
Background and Objective:
Laparoscopic cholecystectomy, though minimally invasive, is associated with significant hemodynamic stress responses due to pneumoperitoneum and anaesthetic interventions. Effective attenuation of these responses is crucial, particularly in patients with cardiovascular risks. This study compares the efficacy of intravenous labetalol, dexmedetomidine, and lignocaine in controlling these responses.
Material and Methods:
In this prospective, randomized controlled study, 150 ASA I–II normotensive patients aged 16–60 years undergoing elective laparoscopic cholecystectomy under general anaesthesia were randomized into three groups (n = 50 each). Group L received labetalol 0.25 mg/kg in 200 ml NS over 10 minutes before induction, Group D received dexmedetomidine 0.5 µg/kg in 200 ml NS over 10 minutes before induction, and Group Lox received lignocaine 1.5 mg/kg as bolus 3 minutes before induction. Hemodynamic parameters (HR, SBP, DBP, MAP) were recorded at baseline, induction, laryngoscopy, and at 3-minute intervals up to 30 minutes post-intubation.
Results:
Dexmedetomidine demonstrated the most consistent and significant control of heart rate and blood pressure throughout the intraoperative period. Labetalol effectively maintained blood pressure but was less effective in controlling heart rate. Lignocaine showed moderate efficacy in attenuating hemodynamic responses. Adverse events were minimal: hypotension occurred in 2% of patients in Group L, and bradycardia occurred in 10% of Group D. No adverse events were noted in Group Lox.
Conclusion:
Dexmedetomidine was superior in maintaining hemodynamic stability during laparoscopic cholecystectomy, with labetalol serving as an effective alternative for blood pressure control. Lignocaine, while safe, was less effective in managing acute hemodynamic fluctuations. Dexmedetomidine may be preferred in patients at risk of exaggerated sympathetic responses.
Keywords:
Dexmedetomidine, Labetalol, Lignocaine, Hemodynamic response, Laparoscopic cholecystectomy, Pneumoperitoneum, General anaesthesia
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