Comparison of Dexmedetomidine versus Fentanyl as Adjuvants to General Anesthesia in Laparoscopic Procedures
Keywords:
Dexmedetomidine, Fentanyl, General Anesthesia, Laparoscopic Surgery, Hemodynamic Stability, Postoperative Analgesia, Recovery Profile, Pneumoperitoneum.Abstract
Background: Laparoscopic surgeries are associated with significant hemodynamic changes due to laryngoscopy, tracheal intubation, and pneumoperitoneum. Various anesthetic adjuvants are used to attenuate these stress responses and improve perioperative outcomes. Dexmedetomidine and fentanyl are commonly employed agents with distinct pharmacological profiles.
Aim: To compare dexmedetomidine and fentanyl as adjuvants to general anesthesia in patients undergoing laparoscopic procedures.
Methods: This prospective, randomized, comparative study was conducted in the Department of Anaesthesiology, St. Joseph’s Hospital, Choondal, Thrissur, Kerala, from 2016 to 2018. A total of 60 patients undergoing elective laparoscopic surgeries under general anesthesia were enrolled and divided into two groups of 30 patients each. Group D received dexmedetomidine, while Group F received fentanyl. Hemodynamic parameters, anesthetic requirements, postoperative pain scores, recovery characteristics, and adverse effects were recorded and analyzed.
Results: The demographic characteristics were comparable between the groups (p > 0.05). Dexmedetomidine provided significantly better control of heart rate and mean arterial pressure during intubation and pneumoperitoneum compared with fentanyl (p < 0.001). The requirements for propofol, isoflurane, and supplemental analgesics were significantly lower in the dexmedetomidine group (p < 0.05). Postoperative pain scores at 1, 4, 8, and 24 hours were significantly reduced in patients receiving dexmedetomidine (p < 0.05). Time to first analgesic request was prolonged, while extubation time and PACU stay were shorter in the dexmedetomidine group. Postoperative nausea and vomiting were significantly less frequent with dexmedetomidine.
Conclusion: Dexmedetomidine is a safe and effective adjuvant to general anesthesia, providing superior hemodynamic stability, reduced anesthetic requirements, better postoperative analgesia, and improved recovery compared with fentanyl in laparoscopic procedures.
