Abstract:
BACKGROUND:
AIM:
To Demonstrate the efficacy of dexmedetomidine in reducing the effects of
post-operative inflammatory responses in patients receiving general anesthesia
with opioids and general anesthesia without opioids but with Dexmedetomidine
for open-abdominal hysterectomy.
OBJECTIVES:
1: To compare the serum levels of postoperative inflammatory markers in patients
receiving anaesthesia by the two different anaesthetic procedures.
2: To compare pain score and duration of postoperative analgesia in the two
groups.
3: To compare the incidence of postoperative nausea and vomiting.
METHODOLOGY:
- Written informed consent taken - Nil by mouth status was confirmed. - IV access was secured with a 20G cannula. - Patients underwent a thorough pre-anaesthetic evaluation with a detailed
history, systemic evaluation, and airway examination. The patient was given
a thorough walk-through of the anaesthetic procedure to be performed and
explained the numeric rating scale. A complete blood panel workup was
done along with preoperative inflammatory serum markers.
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Docusign Envelope ID: 4A7FD7EE-5F58-498D-B6D4-7D0B286B4C8B
Docusign Envelope ID: 4A7FD7EE-5F58-498D-B6D4-7D0B286B4C8B
RESULTS
● The perioperative inflammatory process was affected by the choice of
anaesthetic agent used. This study aimed to evaluate the efficacy of
Dexmedetomidine as a substitute for opioids, which are routinely used.
● When opioids were used, the postoperative inflammatory markers were found to
be significantly higher as compared to preoperative values of the same.
● Results showed that there were minimum variations in the haemodynamic
parameters in the opioid-free group when compared to the opioid-based group.
● In the 24-hours after surgery, patients in the opioid-free group reported lower
pain scores and required lesser rescue analgesia compared to those receiving
opioid, who submitted more requests for additional pain relief.
● It was also found that the MAC for inhalational agents was significantly reduced
in the OF-GA group (MAC 0.6-0.4 of isoflurane).
● Several studies have found that Dexmedetomidine is a very good analgesic and a
good anxiolytic agent. Studies have also found that perioperative stress,
inflammatory responses, PONV, and cognitive dysfunctions were lessened when
dexmedetomidine was used.
CONCLUSIONS
Intraoperative dexmedetomidine-based analgesia resulted in longer postoperative
analgesia with a lesser requirement of rescue analgesia, decreased episodes of
nausea and vomiting, and better control over the inflammatory markers induced by
surgery.
