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Volume 12 Issue 2 ( April- June) 2023

Original Articles

Assessment of effectiveness of Dexmedetomidine, Magnesium sulphate, Lidocaine in multimodal anaesthesia via opioid free analgesia in morbidly obese patients undergoing laparoscopic bariatric surgery under general anaesthesia
Dr. Bharti Shamnani, Dr. Surabhi Dixit, Dr. Chetan Bamoriya, Dr. Rohit Sharma, Dr. Dipti Saxena, Dr. Atul Dixit

Background: The opioid consumption is reduced intraoperatively, effective nocioception and reduction in post operative opioid consumption is achieved. This study was carried out to assess the effectiveness of Dexmedetomidine, Magnesium sulphate, Lidocaine in multimodal anaesthesia via opioid free analgesia in morbidly obese patients undergoing laparoscopic bariatric surgery under general anaesthesia. Materials & Methods: 100 patients undergoing elective laparoscopic bariatric surgery of both genders were divided into 2 sections - Group A and Group B (50 patients in each group). In Group A induction was done with opioid free multimodal anaesthesia regimen using dexmedetomidine, lignocaine and Magnesium sulphate and cisatracurium as the muscle relaxant, maintained with O2, N2O and sevoflurane. In Group B induction was done with opioid free multimodal anaesthesia regime using cisatracurium as the muscle relaxant, maintained with O2, N2O and sevoflurane. Heart rate, Blood pressure, Spo 2 were recorded pre, intra and post operatively. Patients were assessed for VAS score post operatively. Results: No Significant difference in mean SBP was observed before induction (p=0.687) and immediately after induction (p=0.824), however mean SBP was significantly higher at 10 minutes after induction (p=0.017) and after extubation (p=0.020) among those who were not given these 3 drugs. No Significant difference in mean DBP was observed before induction (p=0.589) and immediately after induction (p=0.250), however mean DBP was significantly higher at 10 minutes after induction (p=0.047) and after extubation (p=0.007) among those who were not given these 3 drugs. No Significant difference in mean heart rate was observed before induction (p=0.260) and 10 minutes after induction (p=0.117), however mean heart rates were significantly higher immediately after induction (p=0.001) and after extubation (p=0.001) among those who were not given these 3 drugs compared to those who received the drugs. A significant difference was obtained in terms of using antihypertensive between the two groups. Use of propofol alone (57.4%), propofol with labetolol (10.6%) and propofol with NTG (8.5%) was more among the patients who did not receive the drugs, however those who received,propofol with labetolol and NTG was not used and in maximum patients surgery was performed without the use of antihypertensive (P<0.001). Conclusion: Authors concluded that heart rate, blood pressure were significantly higher at 10 minutes after induction and after extubation among those who were not given those 3 drugs.A significant difference was observed in the use of anti- hypertensives during the procedure between the group that received the 3 drugs and the group that did not.Post operative VAS score was less among the patients who received Dexmedetomidine and Magnesium sulphate and lignocaine intraoperatively.

 
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