title: A comparative study of esmolol and dexmedetomidine on hemodynamic responses to carbon dioxide pneumoperitoneum during laparoscopic surgery.
abstract: BACKGROUND
  Carbon dioxide pneumoperitoneum for laparoscopic surgery increases arterial pressures, heart rate (HR), and systemic vascular resistance. In this randomized, single-blind, placebo-controlled clinical study, we investigated and compared the efficacy of esmolol and dexmedetomidine to provide perioperative hemodynamic stability in patients undergoing laparoscopic cholecystectomy.
  
  
  METHODS
  Sixty patients, of either sex undergoing elective laparoscopic cholecystectomy, were randomly allocated into three groups containing twenty patients each. Group E received bolus dose of 500 μg/kg intravenous (IV) esmolol before pneumoperitoneum followed by an infusion of 100 μg/kg/min. Group D received bolus dose of 1 μg/kg IV dexmedetomidine before pneumoperitoneum followed by infusion of 0.2 μg/kg/h. Group S (control) received saline 0.9%.
  
  
  RESULTS
  Mean arterial pressure and HR in Group E and D were significantly less throughout the period of pneumoperitoneum in comparison to Group S. IV nitroglycerine was required in 45% (9 out of 20) patients in Group S to control intraoperative hypertension, and it was clinically significant in comparison to Group E and D.
  
  
  CONCLUSIONS
  Both esmolol and dexmedetomidine attenuate the adverse hemodynamic response to pneumoperitoneum and provide hemodynamic stability during laparoscopic surgery.
authors.affiliation: Department of Anaesthesiology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Dhurjoti Prosad
authors.initials: DP
authors.lastname: Bhattacharjee
authors.affiliation: Department of Anaesthesiology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Sauvik
authors.initials: S
authors.lastname: Saha
authors.affiliation: Department of Anaesthesiology, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Sanjib
authors.initials: S
authors.lastname: Paul
authors.affiliation: Department of General Surgery, Calcutta National Medical College, Kolkata, West Bengal, India.
authors.forename: Shibsankar
authors.initials: S
authors.lastname: Roychowdhary
authors.affiliation: Department of Pharmacology, Medical College, Kolkata, West Bengal, India.
authors.forename: Shirsendu
authors.initials: S
authors.lastname: Mondal
authors.affiliation: Department of Pharmacology, Medical College, Kolkata, West Bengal, India.
authors.forename: Suhrita
authors.initials: S
authors.lastname: Paul
keywords: Dexmedetomidine; esmolol; hemodynamics; laparoscopic surgery; pneumoperitoneum