European Journal of Cardiovascular Medicine

Introduction: Pre-emptive analgesia provides some short-term (reduction in perioperative pain and acceleration of recovery) and long-term (prevention of chronic pain syndrome) benefits. Therapies that have been tested in pre-emptive trials include NSAIDS, intravenous opioids, IV Ketamine, peripheral local anesthetics, caudal and epidural analgesia, dextromethorphan, gabapentin, magnesium and dexmedetomidine. Aim & Objectives: As dexmedetomidine and magnesium seem to be new weapons in the armamentarium of anaesthesiologists to combat post-operative pain to reduce the requirement of anesthetics intra operatively; we planned this study to compare these two agents in our set up to know exactly their effectiveness in terms of intensity of pain relief and it’s duration, side effects and effect on haemodynamics. Material & Method: This was a double-blinded prospective study in which patients were randomly divided into 2 groups, 55 patients in each group. Group A (n=55) patients were administered intravenous dose of 1.0µg/kg dexmedetomidine for 10 minutes in 100 ml saline followed by a continuous infusion of 0.7µg/kg /hr till completion of the surgery. Group B (n=55) patients were administered intravenous dose of 50mg/kg magnesium sulphate for 10 minutes in 100 ml saline followed by a continuous infusion of 15mg/kg/hr till completion of surgery. Complaints of pruritus, nausea, vomiting, respiratory depression and shivering among all patients were carefully observed, recorded and managed symptomatically. Results: During the intraoperative and postoperative periods, Dexmedetomidine found to show better haemodyamic profile when compared to Magnesium sulphate. The postoperative analgesic scores and the requirement of rescue analgesics, both in terms of frequency and dosage were found significantly lower in Dexmedetomidine group (p=<0.001), compared to Magnesium group. The patient satisfaction scores were significantly higher (P = 0.011) in patients administered Dexmedetomidine, compared to Magnesium. Hypotension and bradycardia were more frequently observed in magnesium group, though no statistical significance could be attributed to this finding. Side effects like vomiting and nausea were more frequent in patients administered Magnesium. Conclusion: Dexmedetomidine as a preemptive analgesic provides better postoperative analgesia with a better haemodynamic profile as well as better patient and surgeon satisfaction with minimal side effects.