Dexmedetomidine in anaesthesia for laparoscopic surgery for acute cholecystitis


  • O A Halushko Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
  • V I Mamchich Shupyk National Medical Academy of Postgraduate Education, Kyiv, Ukraine
  • T V Savchuk Kyiv Regional Clinical Hospital, Kyiv, Ukraine
  • V V Donets Kyiv Regional Clinical Hospital, Kyiv, Ukraine
  • M O Chayka Kyiv Regional Clinical Hospital, Kyiv, Ukraine



laparoscopic cholecystectomy, complications, dexmedetomidine


Background. In laparoscopic cholecystectomy (LCE), general anesthesia has its own characteristics due to the creation of pneumoperitoneum, changes in body position and adsorption of insufflated gas, which causes the occurrence of perioperative complications and requires improvement of anesthesiology programs.

Objective: to determine the efficacy and safety of combined low opioid anesthesia based on dexmedetomidine in complex anesthesia in patients undergoing laparoscopic surgery for acute cholecystitis.

Materials and methods. In total, the study included 163 patients undergoing LCE under general anesthesia. All patients were divided into 3 groups according to the anesthetic care scheme. In Group 1 (n=56), low-opioid anesthesia (dexmedetomidine, lidocaine, fentanyl 1–2 μg/kg/h) and artificial ventilation were performed; Group 2 (n=52): propofol with fentanyl (4–6 μg/kg/h) and artificial ventilation. In Group 3 (n=55): anesthesia with sevoflurane in combination with fentanyl and artificial ventilation.

Results. Hyperdynamic reactions were observed in Group 2 and Group 3 at the beginning of the operation: heart rates and BP values after induction, with intubation in the 3rd, 5th and 7th minute of pneumoperitoneum, were slightly higher in Group 2 and 3 than in Group 1. However, moderate bradycardia was observed in Group 1 more often – in 5 patients (8.92%) than in patients in Group 2 and Group 3 – 2 cases (3.84%) and 2 cases (3.64%), respectively. The total number of injected analgesics during LCE was: in Group 1 – 141.52±23.64 μg, in Group 2 – 426.92±39.41 μg, in Group 3 – 354.75±28.63 μg (p <0.01). Only one patient in Group 1 required ondansetron for the treatment of PONV compared to 5 and 4 in Group 2 and Group 3, respectively (p <0.05). None of the patients in all groups reported “feeling” intraoperative events or “awakening during surgery”.

Conclusions. The use of dexmedetomidine with lidocaine infusion three times reduced the use of opioids in the intraoperative period and to refuse their use in the postoperative period. With the use of low-opioid anesthesia in the postoperative period, the frequency of hypertensive reactions and tachycardia did not increase, but in the postoperative period, these p


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Bashtan LP, Vashchenko OM. Total intravenous anesthesia for laparoscopic cholecystectomy. Zaporozhye Medical Journal, 2011;13(4):5-7. [In Ukrainian]

Bereznytsky JS, Fomin PD. Standards of organization and professionally oriented protocols for providing medical care to patients with urgent surgical pathology of the abdominal organs: scientific method. LLC "Doctor-Media"; 2010. [In Ukrainian]

Shlapak IP, Golubovska OA, Halushko OA. Dehydration syndrome. Acute conditions and emergencies in medical practice. 2015;6:15-9. [In Ukrainian]

Bisgaard T. Analgesic treatment after laparoscopic cholecystectomy: A critical assessment of the evidence. Acute Pain [Internet]. Elsevier BV; 2006 Oct;8(3):148. Available from:

Blaudszun G, Lysakowski C, Elia N, Tramèr MR. Effect of Perioperative Systemic α2 Agonists on Postoperative Morphine Consumption and Pain Intensity. Anesthesiology [Internet]. Ovid Technologies (Wolters Kluwer Health); 2012 Jun 1;116(6):1312–22. Available from:

Khyzhnyak AA, Ievleva VI, Volkova YV, Sharlay K.Yu. Dexmedetomidine as a component of postoperative sedation in patients with severe traumatic brain injury. Emergency medicine. 2017;8(87):62–66. [In Ukrainian]

Song X, Sun Y, Zhang X, Li T, Yang B. Effect of perioperative intravenous lidocaine infusion on postoperative recovery following laparoscopic Cholecystectomy-A randomized controlled trial. International Journal of Surgery [Internet]. Elsevier BV; 2017 Sep;45:8–13. Available from:

Paterson HM. Continuous intravenous lidocaine infusion for postoperative pain and recovery in adults. Techniques in Coloproctology [Internet]. Springer Science and Business Media LLC; 2019 Jan;23(1):69–71. Available from:

Weibel S, Jelting Y, Pace NL, Helf A, Eberhart LH, Hahnenkamp K, et al. Continuous intravenous perioperative lidocaine infusion for postoperative pain and recovery in adults. Cochrane Database of Systematic Reviews [Internet]. Wiley; 2018 Jun 4; Available from:

Savin IA, Fokin MS, Lubnin AYu. Recommendations for intensive care: a guide for doctors. M: LLC "IPK" Indigo "; 2016: 224 p. [In Russian]

Дексмедетомідин в анестезіологічному забезпеченні  лапароскопічних операцій при гострому холециститі




How to Cite

Halushko OA, Mamchich VI, Savchuk TV, Donets VV, Chayka MO. Dexmedetomidine in anaesthesia for laparoscopic surgery for acute cholecystitis. PMJUA [Internet]. 2021 Apr. 29 [cited 2021 Dec. 9];6(1):37-42. Available from:



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