DOI: 10.4103/jica.jica_15_26 ISSN: 2949-7426

Effect of Dexmedetomidine on Renin and Arginine Vasopressin Levels during Propofol- or Sevoflurane-based Anesthesia

Sukanya Samanta, Vanita Ahuja, Deepak Thapa, Sanjeev Palta, Shivani Jaswal, Ashwani K. Dalal, Poonam Goel
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Abstract

Background:

To evaluate the effect of dexmedetomidine on plasma renin and arginine vasopressin (AVP) levels at 30 min of general anesthesia (GA).

Methods:

Fifty-six American Society of Anesthesiologists I–II patients aged 18–60 years undergoing elective abdominal surgeries were randomized into four groups: Group P ( n = 14) – propofol induction and maintenance + saline infusion; Group PD ( n = 14) – propofol induction and maintenance + dexmedetomidine bolus and infusion; Group S ( n = 14) – thiopentone induction and sevoflurane maintenance + saline infusion; and Group SD ( n = 14) – thiopentone induction and sevoflurane maintenance + dexmedetomidine bolus and infusion. All patients received fentanyl 2 µg/kg and vecuronium 0.08–0.1 mg/kg. The primary outcomes were plasma renin and AVP levels at T2 (30 min GA). The four time points were T1 (preinduction 15 min), T2 (30 min GA), T3 (1 h GA), and T4 (24 h postoperatively).

Results:

Renin exhibited a biphasic response with the lowest levels in Group PD at T1, followed by increases at T2–T3 and a return to near-baseline at T4. AVP levels were lowest in Group PD across all time points. AVP in Group P, Group S, and Group SD showed decreasing trends from T2–T4, but values remained higher than in Group PD. Observed urinary sodium excretion at T2 and T3 between groups showed statistical significance with the raw P value, but the raw P value was higher than adjusted α and was therefore statistically nonsignificant. Sevoflurane consumption was significantly reduced with dexmedetomidine ( P = 0.012).

Conclusion:

Dexmedetomidine with propofol reduced plasma renin levels at T1 and AVP levels at all time points.

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