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.