Effect of preoperative nebulized dexmedetomidine on hemodynamic changes in morbidly obese patients undergoing laparoscopic bariatric surgery: a randomized double-blind control trial

Background Patients with morbid obesity receiving laparoscopic bariatric surgeries often experience significant hemodynamic changes during critical perioperative events, including laryngoscopy, intubation, and pneumoperitoneum. Aim To assess the effects of preoperative dexmedetomidine (DEX) nebulization on hemodynamic changes in patients with morbid obesity having laparoscopic bariatric surgeries. Patients and methods This prospective randomized double-blinded controlled work had been conducted on 90 adult morbidly obese patients, 18–50 years, both sexes, with BMI 40–50 kg/m 2 , physical status American Society of Anaesthesiologists III, planned for elective laparoscopic bariatric surgery utilizing general anesthesia. Participants had been randomized equally into two groups and received nebulization with 3 ml of 0.9% saline in group I (control group) or DEX (1 μg/kg) diluted in 3 ml of 0.9% saline in group II (study group) 15 min before being shifted to the operating room with face mask 6 l/min in the preoperative area. Results A significant increase in the level of sedation existed in group II compared to group I ( P <0.05). A significant decrease in heart rate, mean blood pressure, total propofol for induction, intraoperative fentanyl consumption, and pain score existed in group II compared to group I ( P <0.05). Nausea and vomiting had increased significantly in group I than in group II. Bradycardia, hypotension, and hypoxia were comparable among both groups ( P >0.05). Conclusions In individuals with morbid obesity having laparoscopic bariatric surgeries, preoperative nebulized DEX blunts hemodynamic responses to laryngoscope, intubation, and pneumoperitoneum, decreases the amount of total propofol for induction, reduces perioperative opioid consumption with longer duration for analgesia.