Dexmedetomidine versus lidocaine as an adjuvant to general anesthesia for elective abdominal gynecological surgeries

Study objective: The current study was conducted to compare the effect of perioperative administration of intravenous dexmedetomidine versus lidocaine on the perioperative hemodynamic changes, anesthetic consumption, anesthesia induction, and recovery times in patients undergoing elective abdominal gynecological surgeries under general anesthesia. Materials and methods: Ninety female patients undergoing elective abdominal gynecological surgeries were enrolled in the current study. Patients were randomly distributed to one of three equal groups: group L received lidocaine (1.5 mg/kg loading, 2 mg/kg/h infusion), group D received dexmedetomidine (1 mu g/kg loading, 0.5 mu g/kg/h infusion), and group C received isotonic saline 0.9% in the same volume and pattern as the study drugs. Hemodynamic parameters including mean arterial pressure (MAP) and heart rate (HR), anesthetic consumption and induction, recovery times, and time to the first postoperative analgesic demand were recorded. Results: The MAP and HR after endotracheal intubation and in the subsequent recordings were significantly lower in group L and D when compared with group C with no significant difference between group D and L The propofol induction dose and mean end-tidal isoflurane concentration were significantly lower in group L and D when compared with group C and were also significantly lower in group D when compared with group L The intraoperative fentanyl consumption was significantly lower in group L and D when compared with group C with no significant difference between group D and L The anesthesia induction time was significantly shorter in group L and D when compared with group C; it was also significantly shorter in group D when compared with group L with no significant difference as regards the anesthesia recovery time and the response time between the three study groups. The time to the first postoperative analgesic requirement was significantly longer in group D and L when compared with group C; it was also significantly longer in group D when compared with group L. Conclusion: Both dexmedetomidine and lidocaine could be a useful adjuvant to general anesthesia in patients undergoing abdominal gynecological surgeries. However, dexmedetomidine has a better sparing effect on intraoperative anesthetic consumption and longer time to the first postoperative analgesic demand than that of lidocaine with no significant difference between both agents on intraoperative analgesic demand.