Dexmedetomidine and remifentanil as adjuncts to total intravenous anesthesia with propofol
Abstract
Aim: The aim was to compare the effects of dexmedetomidine and remifentanyl in total intraveous anesthesia (TIVA) in laparoscopic cholecystectomy operations.
Methodology: Forty, 18-60 years old, elective laparoscopic cholecystectomy patients were included in the study. In Group D, TIVA was performed by 150 μg/kg/min propofol and 0.5 µg/kg/h dexmedetomidine infusions. In Group R patients, TIVA was performed with 150 μg/kg/min propofol and 0.5 µg/kg/min remifentanil infusions. Systolic blood pressure, heart rate, SpO2, end tidal CO2 were recorded. All infusions were terminated at the end of surgery. Adequate spontaneous respiration, extubation, and response to verbal commands; and Aldrete score ≥ 9 times, postoperative pain scores and vital parameters in the postoperative period were recorded. Patient-controlled analgesia pump was used in all postoperative patients. Total analgesic consumption, patients’ first analgesic needs were recorded.
Results: Intraoperative Systolic blood pressure, diastolic blood pressure and heart rate values remained significantly lower in remifentanyl group compared to those in dexmedetomidine group (p < 0.05). First postoperative analgesia time was shorter and hemodynamic parameters were significantly higher in this group (p < 0.05). Postoperative recovery of dexmedetomidine group remained more stable in terms of VAS values (p < 0.05).
Conclusions: Remifentanil provides a potent intraoperative anesthesia compared with dexmedetomidine; however, dexmedetomidine may be considered in TIVA as an option for a stable postoperative recovery.