Title: Role of Dexmedetomidine on Hemodynamics and Anesthetic Requirement During Elective Intracranial Tumor Surgery - A Prospective Randomized Double Blind Placebo Controlled Study
Authors: Amrita Roy, Suman Sarkar, Sankari Santra, Anusua Banerjee, Shanta Ganguly
DOI: http://dx.doi.org/10.18535/jmscr/v3i8.54
DIDS : 08.2015-XXXXXXX
Background: The objective of present study was to compare the effects of dexmedetomidine with placebo on intraoperative hemodynamics and anesthetic requirements during intracranial tumor surgery. Methods: Ninety patients of ASA physical status 1 or 2, scheduled for elective intracranial tumor surgery, were allocated into group D and group C each consisting of 45 patients. Group D received dexmedetomidine 1 μg/kg over 10 minutes followed by maintenance infusion 0.4μg/kg/hr which was discontinued at skin closure. Group C received normal saline in a similar manner. Anesthesia was induced after 20 minutes of starting the maintenance infusion with propofol and maintained with nitrous oxide in oxygen, continuous infusion of propofol, atracurium and intermittent fentanyl. Heart rate, systolic, diastolic and mean blood pressures were recorded and compared. The requirements of propofol and fentanyl in both groups were also compared. Results: Dexmedetomidine significantly attenuated hemodynamic response at intubation, head pin fixation, skin incision, making of burr hole, opening of dura and at extubation (p 0.00). Total dose of propofol as well as induction and maintenance dose requirement were significantly lower in group D (p < 0.0001). Total and hourly fentanyl requirement was also less in group D (< 0.0001). Patients in group D were extubated earlier than patients in group C (p < 0.0001). Group D patients required less postoperative analgesic (p 0.026). Conclusion: Dexmedetomidine attenuated the hemodynamic response significantly, maintained perioperative hemodynamic stability, decreased extubation time as well as reduced intraoperative propofol and fentanyl and postoperative analgesic requirement in intracranial tumor surgery. Key words: Dexmedetomidine, Propofol, Fentanyl, hemodynamics, Intracranial tumor surgery 1. Basali A, Mascha EJ, Kalfas I, Schubert A. 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