"REDUCING OPIOID DEPENDENCE IN ANESTHESIA: A STUDY ON DEXMEDETOMIDINE AND MAGNESIUM SULFATE AS ALTERNATIVES"
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Abstract
Background: The rising concerns over opioid-related complications, such as addiction, tolerance, and adverse effects, have fueled the pursuit of opioid-free general anesthesia. This has led to the exploration of alternative anesthetic strategies, including the use of dexmedetomidine and magnesium sulphate.
Objective: This study aims to evaluate the efficacy of dexmedetomidine and magnesium sulphate as components of opioid-free general anesthesia, focusing on their impact on anesthetic agent consumption, hemodynamic stability, postoperative recovery, and side effects.
Methods: A prospective, randomized, placebo-controlled study was conducted with 135 patients aged 20-50 years, classified as ASA physical status I or II, undergoing elective surgery under general anesthesia. Patients were randomly allocated into three groups: Group D received dexmedetomidine loading dose 1 µg/kg + inj diclofenac 75mg before induction over a period of 15 min and maintenance 0.5 µg/kg/h throughout the surgery. Group M received magnesium sulphate loading dose 30 mg/kg + inj diclofenac 75mg before induction over a period of 15 min and maintenance 10 mg/kg/h throughout the surgery, and Group C (Control group) – Inj fentanyl of 2mcg/kg + inj diclofenac 75mg before induction and maintenance 1mcg/kg/hr throughout the surgery. The primary outcomes measured included propofol and vecuronium doses, hemodynamic parameters, sedation scores, postoperative analgesia requirements, and side effects.
Results: Dexmedetomidine and magnesium sulphate significantly reduced the doses of propofol and vecuronium compared to the control group. Both agents provided better hemodynamic stability with minimal intraoperative fluctuations. Dexmedetomidine demonstrated superior postoperative analgesic efficacy, reducing the need for rescue analgesia. Group D had higher sedation scores, while Group M had a lower incidence of postoperative shivering. The control group exhibited higher rates of postoperative pain, nausea, and vomiting.
Conclusion: The use of dexmedetomidine and magnesium sulphate in opioid-free general anesthesia effectively reduces the need for opioids and anesthetic agents while maintaining hemodynamic stability and minimizing side effects. This approach offers a promising alternative to traditional opioid-based anesthesia, enhancing patient safety and postoperative recovery.
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Dr. Ruchi Tiwari
Junior resident-3 Index medical college, indore
Dr Sangeeta Bansal Agarwal
HOD & Professor Index medical college, indore