Better Control of Hemodynamic Changes during Laparoscopic Cholecystectomy with Remifentanil Compared to Dexmedetomidine

Abstract Gas insufflation into the peritoneum cavity in laparoscopic surgeries lead to severe hemodynamic changes in patients and frequently anesthetists do some interventions to control the changes. The aim of this study was comparing the efficacy of dexmedetomidine, an α2 adrenergic receptor agonist, with remifentanil, a short-acting opioid, to reduce or prevent these hemodynamic changes and obtain cardiovascular stability. In this double-blind randomized clinical trial study, 60 candidates for laparoscopic cholecystectomy were allocated into two groups receiving intraoperative dexmedetomidine or remifentanil. Induction and maintenance of anesthesia were same in both groups. Systolic and diastolic blood pressure and heart rate were recorded every 10 minutes during the surgery. Heart rate and systolic and diastolic blood pressure showed significant differences between the two groups in some times of the surgery and were significantly lower in remifentanil group. On the other hand, recovery time was longer in dexmedetomidine group significantly. Infusion of remifentanil is more effective than dexmedetomidine to control the hemodynamic changes after insufflations of gas into the peritoneum during laparoscopic cholecystectomy.