Effect of dexmedetomidine infusion on recovery profile and hemodynamics in patients undergoing laparoscopic hysterectomy

Background: Laparoscopic hysterectomy is among the most performed laparoscopic operations. The uterus is removed through a minimally invasive operation. In comparison with conventional open abdominal hysterectomy, laparoscopic hysterectomy results in less blood loss, less scaring, less infection and less post-operative pain. Objective: This work aimed to assess dexmedetomidine (DEX) effect on the quality of recovery profile and intraoperative hemodynamic control in patients scheduled for laparoscopic hysterectomy. Methods: A prospective, randomized, double-blind controlled trial included 100 women (35–65 years), ASA I–II, BMI < 35 kg/m², scheduled for total laparoscopic hysterectomy. Outcomes were postoperative quality of recovery (QoR-15), intraoperative hemodynamics, and pain scores. Results: Recovery quality was significantly higher in DEX group As compared to control group (p < 0.05). DEX significantly reduced extubation time, 24 h opioid dose, and the incidence of headache, dizziness and post-operative nausea and vomiting (PONV). However, intraoperative incidence of hypotension and bradycardia were greater in DEX group (p>0.05). Preoperative values of hemodynamic including heart rate (HR) and mean arterial blood pressure (MAP) were comparable between the two groups (p<0.05). Numerical rating scale (NRS) scores were significantly lower in DEX group than in control group patients at post-anesthesia care unit (PACU) admission (p>0.05). Conclusions: Dexmedetomidine appears to significantly improved recovery quality for patients subjected to laparoscopic hysterectomy and enhanced the postoperative analgesia. Also, it prolonged the time to 1st opioid request and reduced the postoperative opioid dose with significant decline in postoperative incidence of headache and dizziness, but DEX was higher in the incidence of hypotension and bradycardia.