COMPARISON BETWEEN EFFECT OF TWO DIFFERENT DOSES OF INTRAVENOUS DEXMEDETOMIDINE IN ATTENUATING HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION IN ELECTIVE GENERAL SURGERIES UNDER GENERAL ANAESTHESIA

Authors

  • JYOTI KABARA Department of Anaesthesiology, SMS Medical College and Attached Group of Hospitals, Jaipur
  • SHRIPHAL MEENA Department of Anaesthesiology, SMS Medical College and Attached Group of Hospitals, Jaipur
  • PRIYANKA JAIN Department of Anaesthesiology, SMS Medical College and Attached Group of Hospitals, Jaipur
  • VAIBHAV GAGRANI HCG Cancer Centre, Jaipur, Rajasthan-302020, India

DOI:

https://doi.org/10.22159/ijcpr.2024v16i3.4066

Keywords:

Laryngoscopy, Endotracheal intubation, Hemodynamic response, Dexmedetomidine

Abstract

Objective: The process of intubation is a noxious stimuli leading to a period of hemodynamic stress and is accompanied with intense sympathetic activity marked by tachycardia, hypertension and arrythmias.

Methods: It was a randomised, prospective, double-blind study. After approval from the ethics committee 60 patients (ASA class 1 and II) were selected randomly, thirty in each group. Group A (n=30) received 0.5 µg/kg of inj. Dexmedetomidine and Group B received 0.75µg/kg of inj. Dexmedetomidine in 20 ml of normal saline as an infusion over 10 min. The patient was induced with inj Fentanyl 1µg/kg, inj. Propofol and inj. Succinylcholine administered and intubated. The primary outcome variables were heart rate and blood pressure at 1, 3, 5, 10, 15 min after intubation. The secondary outcome variables were the effect on the induction dose of propofol and any adverse effect associated with dexmedetomidine. The statistical package used was spss version 22.

Results: The hemodynamic responses were attenuated in both groups after laryngoscopy and endotracheal intubation, with statistical significant difference between both groups and better obtundation of hemodynamic response in terms of heart rate, systolic, diastolic and mean arterial pressure at all points of time with dexmedetomidine 0.75µg/kg. Sedation scores were more with dexmedetomidine 0.75µg/kg. No significant side effects were there in both groups.

Conclusion: Inj. dexmedetomidine 0.75µg/kg is more effective in attenuating the response to laryngoscopy and endotracheal intubation.

Downloads

Download data is not yet available.

References

Sarkar A, Tripathi RK, Choubey S, Singh RB, Awasthi S. Comparison of effects of intravenous clonidine and dexmedetomidine for blunting pressor response during laryngoscopy and tracheal intubation: a randomized control study. Anesth Essays Res. 2014;8(3):361-6. doi: 10.4103/0259-1162.143144, PMID 25886336.

Stoelting RK. Blood pressure and heart rate changes during short-duration laryngoscopy for tracheal intubation: influence of viscous or intravenous lidocaine. Anesth Analg. 1978;57(2):197-9. doi: 10.1213/00000539-197803000-00009, PMID 565157.

Reid LC, Brace DE. Irritation of respiratory tract and its reflex effect on heart-surgery. Gynaecology Obstetrics. 1940;70:157-62.

Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth. 1987;59(3):295-9. doi: 10.1093/bja/59.3.295, PMID 3828177.

Kamibayashi T, Maze M. Clinical uses of alpha2-adrenergic agonists. Anesthesiology. 2000;93(5):1345-9. doi: 10.1097/00000542-200011000-00030, PMID 11046225.

Keniya VM, Ladi S, Naphade R. Dexmedetomidine attenuates sympathoadrenal response to tracheal intubation and reduces perioperative anaesthetic requirement. Indian J Anaesth. 2011;55(4):352-7. doi: 10.4103/0019-5049.84846, PMID 22013250.

Menda F, Koner O, Sayin M, Ture H, Imer P, Aykac B. Dexmedetomidine as an adjunct to anesthetic induction to attenuate hemodynamic response to endotracheal intubation in patients undergoing fast-track CABG. Ann Card Anaesth. 2010;13(1):16-21. doi: 10.4103/0971-9784.58829, PMID 20075530.

Getler R, Clieghton H, Brown MH, Silvius N. Dexmedetomidine: a novel sedative analgesic agent. Bayl Univ Med Cent Proc. 2001;14(1).

Kamibayashi T, Maze M. Clinical uses of alpha2-adrenergic agonists. Anesthesiology. 2000;93(5):1345-9. doi: 10.1097/00000542-200011000-00030, PMID 11046225.

Stoelting RK, Hiller SC. Textbook of pharmacology and physiology in anesthetic practice. 4th ed. Philadelphia: Lippincott Williams & Wilkins; 2006. p. 340-45.

Kallio A, Scheinin M, Koulu M, Ponkilainen R, Ruskoaho H, Viinamaki O. Effects of dexmedetomidine, a selective alpha 2-adrenoceptor agonist, on hemodynamic control mechanisms. Clin Pharmacol Ther. 1989;46(1):33-42. doi: 10.1038/clpt.1989.103, PMID 2568211.

Sebastian B, Talikoti AT, Krishnamurthy D. Attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation with intravenous dexmedetomidine: a comparison between two doses. Indian J Anaesth. 2017;61(1):48-54. doi: 10.4103/0019-5049.198404, PMID 28216704.

Dhanachandra L, Singh LK. Haemodynamic response to laryngoscopy and endotracheal intubation after intravenous dexmedetomidine: a comparison between two doses. J Evid Based Med Healthc. 2019 Feb;6(8):520-6. doi: 10.18410/jebmh/2019/108.

Sharma N, Mehta N. Therapeutic efficacy of two different doses of dexmedetomidine on the hemodynamic response to intubation, the intubating conditions, and the effect on the induction dose of propofol: a randomized, double-blind, placebo-controlled study. Anesth Essays Res. 2018 Apr-Jun;12(2):566-71. doi: 10.4103/aer.AER_45_18, PMID 29962636.

Published

15-05-2024

How to Cite

KABARA, J., S. MEENA, P. JAIN, and V. GAGRANI. “COMPARISON BETWEEN EFFECT OF TWO DIFFERENT DOSES OF INTRAVENOUS DEXMEDETOMIDINE IN ATTENUATING HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION IN ELECTIVE GENERAL SURGERIES UNDER GENERAL ANAESTHESIA”. International Journal of Current Pharmaceutical Research, vol. 16, no. 3, May 2024, pp. 52-55, doi:10.22159/ijcpr.2024v16i3.4066.

Issue

Section

Original Article(s)