Comparison Of Stress Response During Direct Laryngoscopic Versus Fibreoptic Orotracheal Intubation Following Premedication With Dexmedetomidine.
Journal Title: IOSR Journal of Dental and Medical Sciences (IOSR-JDMS) - Year 2019, Vol 18, Issue 3
Abstract
Introduction Laryngoscopy and intubation is known to cause a significant stress response elicited as sympathetic overactivity. This may be seen as an elevation in heart rate, blood pressure, and catecholamine levels in blood. This can be deleterious in patients with poor cardiac reserve and other comorbidities. Dexmedetomidine is a novel α2 adrenergic agonist which has been shown to attenuate the pressor response following direct laryngoscopic intubation. A comparison of the attenuation of stress response during direct laryngoscopic and fibreoptic intubation following premedication with dexmedetomidine has been studied. Method 60 patients, with ASA grade I and II, of both sexes, aged 18 to 60 years, undergoing elective surgery under general anaesthesia, with endotracheal intubation were enrolled in this study & randomized into two groups; Group I intubated with fibreoptic bronchoscope and Group II intubated with direct laryngoscopy. Both groups were premedicated with dexmedetomidine 30 minutes before the surgery. Results The systolic blood pressure, diastolic blood pressure, mean arterial pressure and heart rate were all significantly lower in the fibreoptic intubation group. Although the time taken for intubation was significantly longer, the stress response were better controlled in the fibreoptic intubation because of less airway manipulation and noxious stimulation. Conclusion Dexmedetomidine attenuates the stress response significantly better in patients intubated with fibreoptic bronchoscope compared to patients intubated by direct laryngoscopy.
Authors and Affiliations
Sulochana Darjee
Keywords
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- EP ID EP554996
- DOI 10.9790/0853-1803067885.
- Views 62
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