To Compare the Hemodynamic Changes with Single Dose of Intravenous Dexmedetomidine versus Midazolam: A Randomized, Prospective Study

Introduction: The stress produced by anesthesia and surgery may produce undesirable hemodynamic effects. Different agents have been used as preoperative medication to eliminate or suppress stress reaction. We hypothesize Dexmedetomidine provides better hemodynamic control as compared to midazolam when used as premedication for patients. In this study, we evaluated effects of pre anesthetic single dose intravenous Dexmedetomidine in a dose of 0.06 mcg/kg body weight with intravenous midazolam 0.05mg/kg body weight on haemodynamic parameters. Methods: This prospective randomized study was conducted on 60 patients undergoing open Cholecystectomy under general anesthesia. After obtaining consent, patients were randomized into group M (received intravenous midazolam 0.05 mg/ kg body weight) and group D (received intravenous Dexmedetomidine 0.6 mcg/kg body weight). The anesthetic technique was standardized for both the groups. The haemodynamic parameters recorded included heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial blood pressure (MAP) at before start of trial drug infusion (baseline), 5 minutes after start of trial drug infusion, 10 minutes after start of trial drug infusion (end of infusion), at induction of anesthesia, at laryngoscopy and intubation, 5/10/20/30/40 minutes after laryngoscopy and intubation. Results: The baseline parameters were comparable in both the groups (P > 0.05). The heart rate was statistically significant between the two groups, being higher in group M as compared to group D (p 0.05). Also, the blood pressures (systolic, diastolic and mean) were statistically significant between the two groups, being higher in group M as compared to group D (p < 0.05). Conclusion: We conclude that a single intravenous pre anesthetic dose of Dexmedetomidine of 0.6mcg/kg body weight blunts haemodynamic response of anesthetic and surgical stress more efficiently and maintain the intraoperative haemodynamic stability in comparison to 0.05mg/kg dose of midazolam.