Dexmedetomidine versus Fentanyl on Stress Response and Pain Control in Adult Patients Undergoing Laparoscopic Surgery

Abstract

aparoscopic procedures have expanded largely both in volume and scope due to their benefits compared to open techniques, such as smaller scars, less pain, earlier mobilization, faster recovery time, and shorter hospital stay. Stress response to surgery encompasses a wide range of endocrinal, metabolic, and immunological effects leading to increase in cortisol level, decrease in insulin concentration, increase in insulin resistance, and consequently high blood glucose. Laparoscopy poses an added challenge to a successful anesthetic plan, mainly because of the significant hemodynamic changes resulting from pneumoperitoneum, CO2 absorption, and patient positioning. In addition to the sympathetically mediated response to laryngoscopy and intubation. Postoperative pain is complex in nature. Postoperative pain that develops after laparoscopy is attributed to abdominal distension, phrenic nerve irritation from CO2, and the surgical trauma itself. Well-controlled postoperative pain decreases morbidity and complications and shortens hospital stay. Anesthetic management in laparoscopic surgeries aims to minimize the pneumoperitoneum-induced hemodynamic response along with an adequate depth of anesthesia and pain control targeting enhancement of recovery by minimal stress