Attenuation of hemodynamic response during laryngoscopy & Endo tracheal intubation comparison between Thiopentone alone and with Dexmedetomidine: A Randomized Clinical Trial.
Journal Title: International Journal of Medical Science and Innovative Research (IJMSIR) - Year 2017, Vol 2, Issue 6
Abstract
Background and Aim Laryngoscopy and endotracheal intubation are traditional method of securing the airway for administration of anaesthesia, but violates patient’s protective airway reflexes and invariably cause haemodynamic changes associated with increased heart rate, increased blood pressure and infrequent disturbance in cardiac rhythm. Such changes arise in response to sympathoadrenal reflex causing release of catecholamine. Aim of our study is to evaluate the efficacy of Dexmedetomidine in the dose of 0.6ug/kg as a single bolus dose, before induction of anesthesia, in attenuating hemodynamic response to laryngoscopy & endotracheal intubation. Method In this randomized, double-blind, placebo-controlled, prospective study an attempt has been made to compare the efficacy of preoperative dexmedetomidine bolus infusions in attenuating the haemodynamic response following laryngoscopy and intubation. One hundred patients in the age group between 18and 50 years, of either sex, ASA- I and II, undergoing various elective abdominal surgeries under general anaesthesia were randomly allocated into two equal groups (n=50). Group-D received infusion of dexmedetomidine o.6 µg/ kg in normal saline. Group-N (control) received only normal saline infusion. The infusions were given 10 minutes before induction of anaesthesia over 10 minutes. Haemodynamic parameters (HR, SBP, DBP and MAP) were recorded before study, drug infusion, after infusion, after induction, during laryngoscopy and intubation and at 1, 2, 3, 5 and 10 minutes after intubation. Results Dexmadetomidine group showed less rise in HR and BP during laryngoscopy and intubation than control group. All haemodynamic parameter changes were also significantly less in Group-D at 1, 2, 3 and 5 minutes after intubation. At 10 minutes after intubation, only DBP and MAP were similar in all groups but HR and SBP still remained significantly high in Group-N. Conclusion Dexmedetomidine can effectively attenuate the haemodynamic response by limiting the extent of rise in heart rate and blood pressure.
Authors and Affiliations
Dr. Debasish Swain
Keywords
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