A Study on the Haemodynamic Stress Responses to Surgeries and the Intra-Operative and Post-Operative Effects of Dexmedetomidine

Abstract

Background: The surgical stress response triggers neuroendocrine and hemodynamic variations that can compromise patient outcomes. Dexmedetomidine, an alpha-2 adrenoceptor agonist, offers sedation, analgesia, and hemodynamic stability without respiratory depression.

Methods: This prospective study was carried out at Deen Dayal Upadhyay Hospital over a six-month period and included 60 adult patients (ASA I/II) undergoing elective surgeries lasting over one hour. Patients were randomized into two groups: one receiving dexmedetomidine and the other a saline placebo. Hemodynamic parameters, anesthetic and analgesic requirements, and postoperative pain scores were monitored.

Results: Dexmedetomidine significantly stabilized heart rate, with a reduction from 78.0 ± 4.1 bpm in the placebo group to 69.0 ± 3.5 bpm before induction (p = 0.0001). Mean arterial pressure (MAP) was lower in the dexmedetomidine group after intubation (96.5 ± 2.0 mm Hg vs. 105.4 ± 3.2 mm Hg, p = 0.0001) and during surgery, with values of 84.3 ± 2.2 mm Hg compared to 89.8 ± 2.5 mm Hg (p = 0.0001). Additionally, patients in the dexmedetomidine group required significantly less propofol (93.5 ± 3.1 mg vs. 110.8 ± 7.5 mg, p = 0.0001) and reported lower postoperative pain scores at 60 minutes (0.5 ± 0.3 vs. 1.2 ± 0.4, p = 0.0001).

Conclusion: Dexmedetomidine is effective as an anesthetic adjunct, enhancing hemodynamic stability and postoperative analgesia while reducing anesthetic and opioid requirements