Assessment of the effect of two different doses of intranasal nitroglycerine spray on attenuation of haemodynamic stress response to pneumoperitoneum in laparoscopic surgeries: A randomised, double-blinded study.

Background and Aims: The stress response to pneumoperitoneum can be deleterious due to its effects on haemodynamics, thereby increasing the morbidity. We intended to compare different doses of nitroglycerine nasal spray to obtund these responses and to look for any side effects. Methods: After ethical committee clearance and clinical trials registration, 70 patients scheduled for laparoscopic cholecystectomy were recruited. Random allocation was done into two groups by a computer generated randomisation table. Group N4 (n = 35) received 400 µg nitroglycerine and group N8 (n = 35) received 800 µg nitroglycerine with an intranasal spray 2 min prior to pneumoperitoneum. All the haemodynamic parameters were monitored at regular intervals. Results: The heart rate was comparable between the groups except at 6 and 10 min of pneumoperitoneum but showed significant increase from baseline within the groups. Mean arterial pressure (MAP) was statistically significant between the groups, being higher in group N4. Within group N4, MAP was significantly low only at 2 min, 4 min of pneumoperitoneum (101.69 ± 12.34 at baseline versus 93.31 ± 8.07 at 2 min and 97.54 ± 9.07 mm Hg at 4 min) and increased significantly at 30 min of pneumoperitoneum (101.69 ± 12.34 at baseline versus 105.66 ± 12.35 mm Hg) and hence, MAP was observed to be around baseline throughout the rest of intraoperative period. Within group N8, there was a significant decrease in mean, systolic and diastolic blood pressure from baseline at most of the time intervals. Conclusion: 800 µg of intranasal nitroglycerine effectively obtunds the hypertensive response associated with pneumoperitoneum as compared to 400 µg without significant side effects.

Comparison of effects of volume-controlled and pressure-controlled mode of ventilation on endotracheal cuff pressure and respiratory mechanics in laparoscopic cholecystectomies: A randomised controlled trial.

BACKGROUND AND AIMS: One of the pathophysiological consequences of pneumoperitoneum is variations in endotracheal cuff pressure (ETTc). Volume-controlled mode and pressure-controlled mode of ventilation being two modes of ventilatory strategies; we intended to find out variations in ETTc governed by respiratory mechanics between these two modes during laparoscopic cholecystectomies. METHODS: After obtaining ethics committee approval, this randomised (1:1), active-controlled, parallel-assigned study was done on 60 patients undergoing laparoscopic cholecystectomies. These patients were allocated into two groups by computer-generated randomisation: Volume-controlled mode (V) and pressure-controlled mode (P). We observed for variations in ETTc which was the primary aim and haemodynamic parameters; respiratory mechanics at baseline (T1), at pneumoperitoneum (T2), after 10 min (T3), 20 min (T4) of pneumoperitoneum and at desufflation (T5). Post-operative laryngotracheal co-morbidities were also observed. Analysis was done using Statistical Package for the Social Sciences version 16.0 (IBM SPSS Statistics, Somers NY, USA). RESULTS: No statistically significant difference was found in both groups either concerning ETTc, haemodynamic parameters or complications. In both groups, ETTc variation was statistically significant when compared from baseline to desufflation (T1 versus T5) and in group V additionally from baseline to time of pneumoperitoneum (T1 versus T2). Group P showed lower peak airway pressure at desufflation and higher mean airway pressure throughout at all the time intervals. CONCLUSIONS: There is no variation in ETTc between the two modes. Group P appears to be better in terms of lower Ppeak and better Pmean.

A new second-generation supraglottic airway device (Ambu® AuraGain•) versus intubating laryngeal mask airway as conduits for blind intubation - A prospective, randomised trial.

BACKGROUND AND AIMS: The Ambu® AuraGain• is a new single-use supraglottic airway device with gastric channel, designed to facilitate intubation. The study aimed to assess the success rates of proper placement and intubation using Ambu® AuraGain• compared with intubating laryngeal mask airway (ILMA). METHODS: One hundred and twenty patients (18-60 years) were enrolled into this prospective, randomised, comparative study. After inducing general anaesthesia, appropriate size ILMA (group I)/Ambu® AuraGain• (group A) was placed as per the manufacturer's recommendations and correct placement was confirmed. Appropriate size endotracheal tube was passed through the device. The success rate of insertion and intubation, number of attempts, Cormack-Lehane grading before insertion and haemodynamics were recorded. Data were analysed using Mantel-Haenszel Chi-square test, Student's t-test and Fisher's exact test. RESULTS: Demographic and airway parameters were uniformly distributed in both the groups. The success rate for insertion was 100% in both devices. The success rate for intubation was 96.6% (58/60) in group I and 36.6% in group A (P < 0.001). In group I, patients with mean thyromental distance >7.62 ± 0.75 cm had higher successful intubation compared with patients with mean thyromental distance <5.25 ± 0.35 cm (P = 0.014). Cormack-Lehane grading did not correlate with intubation attempts or success rate in group I (P = 0.45), whereas in group A the rate of successful blind intubation with Cormack-Lehane grade 1 was 50% (19/38). CONCLUSION: Both devices have 100% insertion success, though Ambu® AuraGain• has lower success rate for facilitating intubation compared with ILMA.

Comparison of Upper Lip Bite Test and Ratio of Height to Thyromental Distance with Other Airway Assessment Tests for Predicting Difficult Endotracheal Intubation.

BACKGROUND AND AIMS: Unanticipated difficult intubation or the failed intubation in operating room and in emergency department is an imperative source of anesthesia-related patient's mortality. The aim of this study is to compare the predictive value of upper lip bite test (ULBT) and ratio of height to thyromental distance (RHTMD) with other commonly used preoperative airway assessment tests for predicting difficult intubation in Indian population. MATERIALS AND METHODS: In this prospective, single-blinded observational study, 260 adult patients of either sex, belonging to American Society of Anesthesiologists physical Status I and II undergoing elective surgical procedure under general anesthesia were included in the study. ULBT, RHTMD, inter-incisor gap, modified Mallampati grade, horizontal length of the mandible, head and neck movements, sternomental distance, and TMD were assessed preoperatively and correlated with Cormack and Lehane's grading during laryngoscopy under anesthesia. Statistical analysis was done by Chi-square and Fisher's exact test. RESULTS: ULBT and RHTMD had highest sensitivity (66.7% and 63.3%), specificity (99.1% and 89.6%), positive predictive value (90.9% and 44.2%), and negative predictive value (96.9% and 95.0%), respectively, when compared to other parameters in predicting difficult airway. CONCLUSION: ULBT and RHTMD may be used as a simple bedside airway assessment tools for prediction of difficult intubation.

Effect of co-administration of different doses of phenylephrine with oxytocin on the prevention of oxytocin-induced hypotension in caesarean section under spinal anaesthesia: A randomised comparative study.

INTRODUCTION: Co-administration of phenylephrine prevents oxytocin-induced hypotension during caesarean section under spinal anaesthesia (SA), but higher doses cause reflex bradycardia. This study compares the effects of co-administration of two different doses of phenylephrine on oxytocin-induced hypotension during caesarean section under SA. METHODS: In this prospective, double-blind study, 90 parturients belonging to the American Society of Anesthesiologists' physical status 1 or 2, undergoing caesarean section under SA were randomised into Group A: oxytocin 3U and phenylephrine 50 µg, Group B: oxytocin 3U and phenylephrine 75 µg, Group C: oxytocin 3U and normal saline, administered intravenously over 5 min after baby extraction. The incidence of hypotension (the primary outcome), rescue vasopressor requirement and side effects were recorded. Statistical analyses were with analysis of variance, Kruskal-Wallis, chi-square and Fisher's exact tests. RESULTS: Demographic parameters such as age, height, weight, level of sensory block at 20 min and duration of surgery were comparable in all the groups. The incidence of hypotension (Group A - 90%, Group B - 10%, Group C - 98%, P = 0.001), magnitude of fall in mean arterial pressure (Group A-15.03 ± 6.12 mm of Hg, Group B - 6.63 ± 4.49 mm of Hg and Group C-13.03 ± 3.39 mm of Hg, P < 0.001) and rescue vasopressor requirement (Group A-45 ± 15.25 mg, Group B-5 ± 15.25, Group C-91.66 ± 26.53, P < 0.001) were significantly lower in Group B compared to A and C. CONCLUSION: Co-administration of phenylephrine 75 µg with oxytocin 3U reduces the incidence of oxytocin-induced hypotension compared to phenylephrine 50 µg with oxytocin 3U during caesarean section under spinal anaesthesia.

Study of Effect of Magnesium Sulphate in Management of Acute Organophosphorous Pesticide Poisoning.

BACKGROUND: Organophosphorus compound poisoning (OPCP) is a major public health problem in developing countries like India. Atropine and oximes remain the main-stay of management. Magnesium sulfate (MgSO4) has shown benefit in the management of OPCP. AIMS: This study was designed to assess the effect of MgSO4 on outcome in OPCP patients admitted to Intensive Care Unit (ICU). SETTINGS AND DESIGN: Double-blind prospective randomized clinical trial in an ICU of tertiary care institution. METHODS: One hundred patients (50 in each group) of OPCP, confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged between 18 and 60 years were studied. Magnesium group (Group M) received 4 g of 20% MgSO4 infusion over 30 min at admission to ICU, control group (Group C) received normal saline placebo in the same manner. Patients were assessed for the need for intubation, requirement of atropine, duration of mechanical ventilation, duration of ICU stay, and its effect on mortality. STATISTICAL ANALYSIS: Chi-square test and Fisher's exact test for categorical data, independent sample t-test, and paired t-test for nominal data. RESULTS: Demographics and basal serum magnesium levels were comparable. Atropine requirement was higher in Group C (74.82 ± 22.39 mg) compared to Group M (53.11 ± 45.83 mg) (P < 0.001). A total of 33 patients in Group C and 23 patients in Group M required intubation, respectively (P = 0.043). The mean duration of mechanical ventilation was 4.51 ± 2 days in Group C compared to 4.13 ± 1.6 days in Group M (P = 0.45). ICU stay was 5.36 ± 2.018 days in Group C compared to 4.54 ± 1.581 days in Group M (P = 0.026). There was no significant difference in mortality between the groups. CONCLUSION: Four grams of MgSO4 given to OPCP patients within 24 h of admission to ICU, decreases atropine requirement, need for intubation, and ICU stay.

Effect of melatonin on duration of delirium in organophosphorus compound poisoning patients: A double-blind randomised placebo controlled trial.

BACKGROUND AND AIMS: Organophosphate compound poisoning (OPCP) is associated with high incidence of delirium. Melatonin has been tried in the treatment of delirium and has shown a beneficial effect in OPCP. This study was conducted to know the effect of melatonin on duration of delirium and recovery profile in OPCP patients. METHODS: Double-blind randomised placebo control trial in which 56 patients of OPCP confirmed by history and syndrome of OPCP with low plasma pseudocholinesterase, aged >18 years and weighing between 50 and 100 kg, and Acute Physiology and Chronic Health Evaluation II score of <20 were studied. Group M (n = 26) received tablet melatonin 3 mg and Group C (n = 30) received placebo tablet at 9 PM, every night throughout the Intensive Care Unit (ICU) stay. Delirium was assessed using the Confusion Assessment Method for ICU, thrice a day. Sedation was provided with injection midazolam, fentanyl and lorazepam. Duration of mechanical ventilation, vital parameters, ICU stay, sedative and atropine requirement, were recorded. RESULTS: The time taken to be delirium free was significantly lower in Group M (6 ± 2.92 days) compared to Group C (9.05 ± 2.75 days) (P = 0.001) and prevalence of delirium was significantly decreased in Group M compared to Group C from day 3 onwards. The requirement of midazolam (Group M - 2.98 ± 4.99 mg/day, Group C - 9.68 ± 9.17 mg/day, P < 0.001) and fentanyl (Group M - 94.09 ± 170.05 µg/day, Group C - 189.33 ± 156.38 µg/day, P = 0.03) decreased significantly in Group M. There was no significant difference in the average atropine consumption (P = 0.27), duration of mechanical ventilation (P = 0.26), ICU stay (P = 0.21) and the number of patients requiring mechanical ventilation (P = 0.50). CONCLUSION: Orally given melatonin in organophosphate compound poisoning patients reduces the duration of delirium and the requirement of sedation and analgesia.

How to write a research proposal?

Writing the proposal of a research work in the present era is a challenging task due to the constantly evolving trends in the qualitative research design and the need to incorporate medical advances into the methodology. The proposal is a detailed plan or 'blueprint' for the intended study, and once it is completed, the research project should flow smoothly. Even today, many of the proposals at post-graduate evaluation committees and application proposals for funding are substandard. A search was conducted with keywords such as research proposal, writing proposal and qualitative using search engines, namely, PubMed and Google Scholar, and an attempt has been made to provide broad guidelines for writing a scientifically appropriate research proposal.

THE EFFECT OF A SINGLE DOSE OF MAGNESIUM SULPHATE AS AN ADJUVANT TO EPIDURAL BUPIVACAINE FOR INFRAUMBILICAL SURGERIES: A PROSPECTIVE DOUBLE-BLIND, RANDOMIZED CONTROL TRIAL.

CONTEXT: Epidural anesthesia provides the advantage of segmental blockade and many adjuvants have been added to shorten the onset of action, improve the quality of analgesia and prolong the duration of analgesia. Magnesium sulphate(MgSO4) by virtue of its anti-iociceptive property has been administered by various routes. AIM: To assess the effect of MgSO4 on the duration of onset of action of injection bupivacaine for epidural anesthesia in infraumbilical surgeries. MATERIALS AND METHODS: A prospective, double-blind, randomized control study was conducted in 40 patients. Group M received 15 ml of bupivacaine 0.5% + 1 ml of 50 mg MgSO4 and Group C received 15 ml of bupivacaine 0.5% + 1 ml of normal saline via epidural route. Onset time of the sensory and motor blockade were the primary outcomes studied. Highest level of sensory block, time for two segment regression, hemodynamic parameters, side effects were the secondary parameters. RESULTS: There was a significant difference between the groups in the mean onset time of sensory blockade at T8, 12.85 ± 2.32 min in Group M and 16.75 ± 1.74 min in Group C. Median level of sensory blockade was comparable. Mean onset time of motor blockade was 13.85 ± 3.28 min in Group M and 23.25 ± 3.35 min in Group C which was clinically and statistically significant. Time for two segment regression of sensory blockade was 95.75 ± 11.84 min in Group M and 55.5 ± 8.57 min in Group C which was significant. Hemodynamic parameters and side effects were comparable. CONCLUSION: Magnesium sulphate as an adjuvant provides rapid onset of epidural anesthesia and prolongs the duration of analgesia with minimal side effects.

EFFECT OF DEXMEDETOMIDINE ON HEMODYNAMIC PARAMETERS DURING EXTUBATION. A PROSPECTIVE RANDOMIZED DOUBLE BLIND STUDY.

BACKGROUND: Extubation is known to produce significant hemodynamic disturbances. There is a need to avoid increase in heart rate and blood pressure in hypertensive and cardiac patients and in vascular, neuro and intraocular surgeries. AIMS: To study the ability of dexmedetomidine to attenuate the hemodynamic responses during extubation. MATERIALS AND METHODS: 80 patients of ASA Grade I-II aged 18-50 years received standard anesthesia. At the closure of skin incision, patients were randomly allocated to receive either dexmedetomidine 0.5 µg/kg (Group D) or saline placebo (Group C) intravenously over 10 minutes in a double-blind design. Heart rate (HR), systolic, diastolic and mean arterial pressures (SBP, DBP, MAP) were assessed before, during- and after extubation. Time to eye opening and extubation, sedation, complications such as coughing, laryngospasm, bronchospasm and desaturation were recorded. RESULTS: HR, SBP, DBP and MAP were comparable to basal values in group D at extubation and lower than baseline values post-extubation but significant increase was noted in group C (P <0.001). Time to extubation and eye opening were prolonged in Group D (P <0.001). Incidence of hypotension was more in group D (22%) but was transient. Incidence of coughing was lower in Group D than in group C (P <0.001). Patients in group D were more sedated for 30 minutes post extubation. CONCLUSION: Dexmedetomidine 0.5 µg/kg given before extubation attenuates hemodynamic reflexes during emergence from anesthesia without causing undue sedation, but prolongs time to extubation.

Comparison of ventilatory efficacy and airway dynamics between ProSeal laryngeal mask airway and endotracheal tube in adult patients during general anesthesia.

BACKGROUND AND AIMS: Studies have demonstrated minimal hemodynamic variation and postoperative complications with ProSeal laryngeal mask airway (PLMA) compared to endotracheal tube (ETT). Hence, a study was conducted to compare the ventilatory parameters and airway dynamics required to maintain normocarbia and stable hemodynamics with PLMA and ETT. MATERIAL AND METHODS: A prospective, randomized, single blinded study was conducted on 60 patients aged 20-40 years of American society of anesthesiologists class I and II, divided into Group PLMA and Group ETT. Standard anesthesia protocol was instituted. Group PLMA received PLMA sizes as per manufacturer's recommendations and group ETT received appropriate sized cuffed ETT. Patients were initially ventilated at 14 bpm, I:E ratio 1:2, tidal volume (Vt) 6 ml/kg and later adjusted to maintain end tidal carbon dioxide (EtCO2) between 35 and 40 mmHg. Peak airway pressure (Ppeak), compliance (Compl.), Vt, airway resistance (Raw), hemodynamic parameters, oxygen saturation (SpO2) and EtCO2 were recorded throughout surgery. Postoperative complications if any, were noted. RESULTS: Demographic parameters, Raw, EtCO2, SpO2 were comparable between groups. Ppeak was lower and Vt needed to maintain EtCO2 of 35-40 mmHg was lesser in Group PLMA. Compl was low for 5 min after insertion of PLMA. Heart rate was significantly reduced at 1 min post insertion; blood pressures were significantly lower upto 2 min after insertion and post removal in group PLMA. Incidence of cough was significantly lower in group PLMA. CONCLUSION: ProSeal laryngeal mask airway maintains adequate ventilation at lower Vts and minimal peak pressures, has lesser hemodynamic variations and lower incidence of postoperative cough compared to ETT.

Comparative study of two doses of intrathecal dexmedetomidine as adjuvant with low dose hyperbaric bupivacaine in ambulatory perianal surgeries: A prospective randomised controlled study.

BACKGROUND AND AIMS: Dexmedetomidine (DMT), as intrathecal adjuvant has been shown to successfully prolong duration of analgesia but delay the motor recovery. Hence, this study was designed to find out the dose of DMT which can provide satisfactory analgesia without prolonging motor block. METHODS: A total of 50 patients scheduled for elective perianal surgeries were randomly allocated to Groups C or D (n = 25). Group D received hyperbaric bupivacaine 0.5% 4 mg + DMT 5 µg and Group C received hyperbaric bupivacaine 0.5% 4 mg + DMT 3 µg intrathecally. Onset and duration of sensory and motor blockade, duration of analgesia, time for ambulation and first urination were recorded. Adverse effects if any were noted. RESULTS: Demographic characters, duration of surgery were comparable. The onset of sensory block to S1 was 9.61 ± 5.53 min in Group C compared to 7.69 ± 4.80 min in Group D (P = 0.35). Duration of sensory (145.28 ± 83.17 min - C, 167.85 ± 93.75 min - D, P = 0.5) and motor block (170.53 ± 73.44 min - C, 196.14 ± 84.28 min, P = 0.39) were comparable. Duration of analgesia (337.86 ± 105.11 min - C, 340.78 ± 101.81 min - D, P = 0.9) and time for ambulation (252.46 ± 93.72 min - C, 253.64 ± 88.04 min - D, P = 0.97) were also comparable. One patient in each group had urinary retention requiring catheterization. No other side effects were observed. CONCLUSION: Intrathecal DMT 3 µg dose does not produce faster ambulation compared to intrathecal DMT 5 µg though it produces comparable duration of analgesia for perianal surgeries.

Intrathecal dexmedetomidine as adjuvant for spinal anaesthesia for perianal ambulatory surgeries: A randomised double-blind controlled study.

BACKGROUND AND AIM: The newer trend in regional anaesthesia for ambulatory anorectal surgeries advocate use of lower dose of local anaesthetic, providing segmental block with adjuvants such as opioids and α2 agonists to prolong analgesia. The current study investigated effects of addition of 5 µg of dexmedetomidine to 6 mg of hyperbaric bupivacaine on duration of analgesia, sensory and motor block characteristics for perianal ambulatory surgeries. METHODS: This study is a prospective randomised controlled double blind study. Forty adult patients between 18 and 55 years of age were divided into 2 groups. Group D received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with injection dexmedetomidine 5 µg in 0.5 ml of normal saline and Group N received intrathecal 0.5% hyperbaric bupivacaine 6 mg (1.2 ml) with 0.5 ml of normal saline. The parameters assessed were time to regression of sensory blockade, motor blockade, ambulation, time to void, first administration of analgesic. Statistical analysis was done using appropriate tests. RESULTS: Time for regression of sensory level and time for first administration of analgesic were prolonged in Group D (430.05 ± 89.13 min, 459.8 ± 100.9 min, respectively) in comparison to Group N (301.10 ± 94.86 min, 321.85 ± 95.08 min, respectively). However, the duration of motor blockade, time to ambulation, and time to void were also significantly prolonged in Group D (323.05 ± 54.58 min, 329.55 ± 54.06 min, 422.30 ± 87.59 min) than in Group N (220.10 ± 63.61 min, 221.60 ± 63.84 min, 328.45 ± 113.38 min). CONCLUSION: Intrathecal dexmedetomidine 5 µg added to intrathecal bupivacaine 6 mg as adjuvant may not be suitable for ambulatory perianal surgeries due to prolongation of motor blockade.

"ANESTHETIC SPARING EFFECT OF INTRAOPERATIVE LIGNOCAINE OR DEXMEDETOMIDINE INFUSION ON SEVOFLURANE DURING GENERAL ANESTHESIA".

BACKGROUND: Lidocaine and Dexmedetomidine are known to blunt the stress response to surgery, and have anesthetic sparing activity. This study was designed to evaluate and compare the anesthetic sparing effect of intravenous lidocaine with Dexmedetomidine infusion during sevoflurane based general anesthesia and also to assess their effects on hemodynamic parameters. METHODS: Forty-eight ASA I-II patients aged between 18-55 yr, scheduled for abdominal surgery lasting less than 2 h, performed under general anesthesia were enrolled and they were randomly allocated to Lidocaine(L), Dexmedetomidine (D) and Saline (S) groups of 16 each. Group L received Inj. Lidocaine at 1.5 mg/kg bolus over 10 min followed by infusion at 1.5 mg/ kg/hr, and Group D received Inj. Dexmedetomidine at 1 µg/kg over 10 min, followed by 0.5 µg/ kg/hr infusion till the end of surgery. Group S received similar volume of normal saline. Anesthesia was induced with Inj. Propofol and maintained with N2O in O2 and sevoflurane, keeping entropy between 40-60. The hourly sevoflurane requirements and hemodynamic parameters were recorded. Results: Demographic parameters, entropy and duration of surgery were comparable. Mean sevoflurane requirement at 1st h in group L and D were 11.6 ± 1.5 ml, and 10.2 ± 1.3 ml respectively, while it was 16.7 ± 4.1 ml in Saline group (P < 0.001). Sevoflurane requirements were significantly lesser in group D compared to group L (P = 0.009). The Mean ET(sevo) concentrations in Group L, D and S were 0.8 ± 0.3, 0.8 ± 0.4 and 1.2 ± 0.5 (P = 0.021), respectively. CONCLUSIONS: Both drugs produce significant anesthetic sparing effect during sevoflurane based general anesthesia, but dexmedetomidine has better sparing effect than lignocaine.

Effect of intraoperative Dexmedetomidine infusion on Sevoflurane requirement and blood glucose levels during entropy-guided general anesthesia.

BACKGROUND: Dexmedetomidine has been shown to blunt the stress response to surgery. Hence a study was designed to evaluate the effect of intravenous (IV) Dexmedetomidine infusion during general anesthesia for abdominal surgeries on blood glucose levels and on Sevoflurane requirements during anesthesia. MATERIALS AND METHODS: Forty patients scheduled for abdominal surgery under general anesthesia were divided into Dexmedetomidine (D) group and Placebo (P) group of 20 each. Group D received a loading dose of Inj. Dexmedetomidine at 1 µg/kg/10 min diluted to 20 mL, followed by maintenance with 0.5 µg/kg/h., till the end of surgery. Group P received similar volume of IV normal saline. Anesthesia was maintained with nitrous oxide in oxygen and Sevoflurane keeping entropy between 40 and 60. Data were analyzed using students t test, chi square test and Fisher Exact test as applicable. RESULTS: During the first postoperative hour, Dexmedetomidine group showed blood glucose levels of 118.2 ± 16.24 mg/dL, compared to placebo group which was 136.95 ± 19.76 mg/dL and it was statistically significant (P < 0.01). Mean hourly Sevoflurane requirement in Group D was 11.10 ± 2.17 mL, compared to 15.45 ± 3.97 mL in placebo group. In peri-operative period, the heart rate and MAP were significantly lower in Group D, when compared to placebo. Patients in Group D were better sedated and post-operative pain score was better in Group D compared to Group P. CONCLUSION: IV Dexmedetomidine was effective in blunting stress response to surgical trauma as indicated by lower blood glucose levels, and reduces Sevoflurane requirements during entropy guided general anesthesia without affecting time for extubation.