Vol. 7, Issue 1, Part A (2025)

Background: Laparoscopic cholecystectomy is minimally invasive, but pneumoperitoneum and surgical stimulation cause significant hemodynamic and physiological stress reactions. Fentanyl, an opioid analgesic, and Dexmedetomidine, an α2-adrenergic agonist, are often used to alleviate these symptoms.

Objective: This study aims to assess Fentanyl and Dexmedetomidine’s impact on the patient’s blood pressure during surgery, postoperative relief, and the need for pain management.

Methodology: The prospective experimental study contained 60 ASA I and II surgical patients undergoing laparoscopic cholecystectomy. A total of 30 subjects were randomly assigned to each of the two groups: Fentanyl was given to Group A, and Dexmedetomidine was given to Group B. During the surgery, we monitored heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), the time required to have a Modified Aldrete Score >9, opioid and other pain medication given afterward, the level of sedation and complications.

Result: Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were all lower in Group B (Dexmedetomidine) than in Group A (Fentanyl) values (p<0.05). Group B achieved an Aldrete score of >9 faster than Group A (12.4±3.7 min vs. 16.4±3.2 min, p=0.008). The average time until the administration of analgesics was longer for Group B compared to Group A (48.2±11.4 min vs. 27.6±9.7 min; p=0.002). During the first 4 hours after surgery, the sedation scores were significantly higher in Group A. Group B experienced more cases of hypotension and bradycardia. In contrast, Group A had more instances of PONV and respiratory depression.

Conclusion: Dexmedetomidine helps maintain stable blood pressure during the procedure, leads to a faster recovery, and requires fewer analgesic drugs than Fentanyl. Yet, general anesthesia can sometimes result in both hypotension and bradycardia.