Attenuation of Stress Response during Intubation for Laparoscopic Procedures: A Comparative Study between Intravenous Dexmedetomidine and Lidocaine

Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 9

Abstract

Introduction: During laryngoscopy and endotracheal intubation, one of the most dreaded complications is hemodynamic instability which is a well-archived certainty and this response in most susceptible patients induces myocardial ischemia or infarction, left ventricular failure and cerebral hemorrhage due to the strong sympathetic response during the procedure. The aim of the study: This study was aimed to compare the effect of dexmedetomidine and lidocaine on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing elective laparoscopic procedures under general anaesthesia. Materials and Methods: A total of sixty patients were selected and randomized into two groups of thirty patients each: dexmedetomidine-intervention group and lidocaine-control group. Inj. Dexmedetomidine by means of infusion pump was given prior to anesthetic induction, at a rate of 1g/kg IV over a period of 10 min, to all intervention group patients. Three minutes after the completion of infusion, patients were induced with general anaesthesia. As a standard procedure, plain preservative-free 2% lidocaine was given at a rate of 1.5 mg/kg IV bolus to all patients in the control group 1.5 minutes prior to laryngoscopy. Baseline parameters such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP), were recorded before administration of the drugs under study, at intubation, and at 1 min & 3 min after intubation. Results: The changes in mean heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure values were significantly lower in Dexmedetomidine group when compared to the lidocaine group. Conclusions: Dexmedetomidine when used as a pre-anesthetic medication significantly suppresses the sympathoadrenal response to laryngoscopy and endotracheal intubation without influencing intraoperative cardiovascular stability.

Authors and Affiliations

Mu. Raajaram

Keywords

Related Articles

Haemodynamic Responses to Laryngoscopy and Intubation in Patients Undergoing Craniotomy: Comparison between Macintosh and Mccoy Laryngoscope Blades, with Monitoring of Entropy

Aim: To compare the haemodynamic responses, during laryngoscopy and intubation, using Macintosh and McCoy blades, in patients of ASA grades I and II, undergoing craniotomy for supratentorial lesions, under general anaest...

Effectiveness of Preoperative Audiovisual Information in Reducing Patient Anxiety about Spinal Anaesthesia: A Randomized Controlled Study

Aims: A high incidence of anxiety about anesthetic procedure is seen in patients undergoing surgical procedures, which can be related to their unawareness about anaesthesia and anaesthetist's role in perioperative care....

Comparative Study between Ropivacaine 0.2% Versus Bupivacaine 0.2% in Epidural Labor Analgesia

Introduction: The epidural analgesia is popular and effective method of labour analgesia since the parturient remains awake, pain free and comfortable, watches her delivery and immediately can feed her baby. Bupivacaine...

Comparison of Premixed Versus Sequential Administration of Fentanyl as an Adjuvant to Intrathecal Hyperbaric Bupivacaine in Infra-Umbilical Surgeries: A Randomized Controlled Study

Opioids and local anaesthetics administered together intra-thecally have potent synergistic analgesia. Aims and Objectives: To compare the efficacy of premixed versus sequential administration of fentanyl as an adjuvant...

Effects of Clonidine on Spinal Anesthesia with Hyperbaric Bupivacaine

Background: Clonidine is one of the drugs that have been extensively studied by administering through oral, intravenous and intrathecal routes to prolong the spinal anesthesia. A lot of studies have shown oral clonidine...

Download PDF file
  • EP ID EP538597
  • DOI 10.21088/ijaa.2349.8471.5918.6
  • Views 82
  • Downloads 0

How To Cite

Mu. Raajaram (2018). Attenuation of Stress Response during Intubation for Laparoscopic Procedures: A Comparative Study between Intravenous Dexmedetomidine and Lidocaine. Indian Journal of Anesthesia and Analgesia, 5(9), 1461-1468. https://europub.co.uk/articles/-A-538597