Background and Aim: Dexmedetomidine, a selective alpha-2 adrenergic agonist, has been used to blunt various stress responses during general anaesthesia including that of pneumoperitoneum. It also has synergistic effects when used as an adjuvant with anaesthetic agents. Our study aimed to assess the efficacy of dexmedetomidine without any initial bolus at an infusion dose of 0.5 mcg/kg/hour, in attenuating the haemodynamic stress response to pneumoperitoneum in laparoscopic surgeries and evaluate the efficacy of its synergistic effects at this dose. Methods: 60 American Society of Anaesthesiologists physical status I/II patients, 18-60 years, undergoing elective laparoscopic surgery were randomized into 2 groups: Group I received dexmedetomidine and group II normal saline @ 0.5 mcg/kg/hour intravenously, started before premedication till the end of pneumoperitoneum. Heart rate and blood-pressure were monitored continuously. Anaesthetic agents and analgesics were titrated to maintain entropy of 40-60. Results: Compared to group II, group I showed significant blunting of HR and BP rise during entire duration of pneumoperitoneum (p<0.05). There was reduced requirement for propofol, fentanyl and isoflurane, showing significant MAC sparing effect (p<0.0001) in group I vs group II. Patients in group I also exhibited earlier emergence, without residual sedation (p<0.0001). Conclusion: Without any initial bolus, Dexmedetomidine infusion @0.5 mcg/kg/hour, when started timely before induction of pneumoperitoneum, effectively attenuated the hemodynamic stress response to pneumoperitoneum, significantly reduced anaesthetic/analgesic requirements exhibiting good synergistic effect, while maintaining depth of anaesthesia, resulting in early and smooth emergence. This dose achieves maximum efficacy with minimal side effects.