Anesthésie et recherche clinique
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A Prospective Randomized Comparative Study of Intravenous Dexmedetomidine versus Magnesium Sulphate as an Adjunct during Anesthesia for Laparoscopic Cholecystectomy

Devyani J Desai, Shailee Shah and MR Upadhyay

Introduction: The hemodynamic response to endotracheal intubation, pneumoperitoneum and extubation can
increase perioperative morbidity and mortality. Dexmedetomidine is a highly selective alpha 2 adrenoreceptor
agonist, routinely used to attenuate hemodynamic stress response. Magnesium Sulphate also inhibits
catecholamine release from adrenal glands. It can modulate the neurohumoral responses observed during
laparoscopic surgeries.
Aim and objectives: To compare the effectiveness of intravenous Dexmedetomidine and Magnesium Sulphate
as an adjunct during anesthesia for laparoscopic cholecystectomy.
Materials and method: After taking permission from institutional ethical committee, patients of 18-60 years of
either sex and American society of anesthesia grade I and II were divided into two groups of 35 each. In Group D,
Dexmedetomidine 1 μg/kg and Group M, Magnesium Sulphate 40 mg/kg over 15 min in 20 ml NS were given
intravenously before induction of general anesthesia. Peri operative hemodynamic parameters were noted as well
as postoperative analgesia and sedation were assessed.
Results: There was fall in mean arterial pressure and heart rate after giving Magnesium Sulphate and
Dexmedetomidine infusion, which further decreased after giving propofol in both the groups. There was rise in both
the parameters after intubation and pneumoperitoneum but remained lower than the baseline throughout the
intraoperative period in both the groups. The fall in mean arterial pressure and heart rate was more in Magnesium
Sulphate group than in Dexmedetomidine group (p<0.001). Postoperative analgesia and sedation were comparable
in both the groups.
Conclusion: Both, Dexmedetomidine 1 μg/kg and Magnesium Sulphate 40 mg/kg were able to attenuate
hemodynamic response to anesthesia and surgical manipulation during laparoscopic cholecystectomy. However,
Magnesium Sulphate produced better hemodynamic stability compared to Dexmedetomidine.