الفهرس 
Pharmacology of dexmedetomidineOnly 14 pages are availabe for public view
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Abstract
Obese patients may be sensitive to the respiratory depressant effect of opioid drugs and more likely to require postoperative ventilation to avoid hypoxic episodes. Dexmedetomidine is a specific α2-adrenergic receptor agonist with antinociceptive and sedative properties. Reports indicate that dexmedetomidine decreased anesthetic requirements during surgery, provided postoperative analgesia, and decreased opioid use in the postanesthesia care unit (PACU). Methods: Fifty hospitalized morbidly obese patients undergoing elective laparoscopic Roux-en-Y gastric bypass (RYGBP) surgery under propofol-based total intravenous anesthesia (TIVA). All patients were ASA: II or III, there ages were between 26-50 years, of both sexes, and there BMI ˃ 40 mg.kg ̵². All patients received standard general anesthesia intraoperatively Immediately after induction of anesthesia, patients were randomly allocated to either of two equal-sized group using a series of closed envelops. In Group D, (Study group) dexmedetomidine (0.7 µg/kg LBW) is given intravenously over 10 minutes as a loading dose. In Group P, (Control group) a 50 ml solution of 0.9%, sodium chloride was substituted for dexmedetomidine. anesthetic requirements, perioperative hemodynamics, and postoperative pain, sedation, Respiratory parameters, nausea, vomiting and analgesic consumption were tabulated. Results: two study Groups were similar with respect to age, body mass index, and sex. Propofol consumption was significantly less in Group D. mean intraoperative, mean arterial pressure (MAP) and heart rate were all significantly lower in Group D, Patients in the Group D consumed significantly less 24h morphine by PCA analgesia and also had significantly higer postoperative sedation score There was no statistically significant difference between the two groups as regard lowest postoperative SpO2, respiratory rate, and postoperative nausea and vomiting (PONV). Conclusion: intraoperative infusion of dexmedetomidine may be an attractive option during laparoscopic RYGBP surgery as it decreased the total amount of propofol required to maintain anesthesia, offered better control of intraoperative and postoperative hemodynamics, decreased postoperative pain level and decreased the total amount of morphine.