Dexmedetomidine May Attenuate Cardiovascular Stress During Endotracheal Intubation
Journal Title: PARIPEX-Indian Journal of Research - Year 2016, Vol 5, Issue 1
Abstract
Background: Endotracheal intubation drives major sympathetic stimulation in the perioperative period and is responsible for haemodynamic disturbances. Transient rise of heart rate and blood pressure during this time may be detrimental in many patients who are already compromised due to their cardiovascular co-morbidities. Various drugs and methods are in practice to blunt or completely attenuate this reflex sympathetic stimulation. The sedative and analgesic effects of Dexmedetomidine are proven in many studies and it is also found to obtund sympathetic stimulation to major noxious stimuli. Method: A study was carried out to evaluate the effectiveness of Dexmedetomidine in the attenuation of stress response to intubation. All the patients were premedicated with Fentanyl and Midazolam. The study group received Dexmedetomidine 1mcg/Kg in 100ml saline over 15 min and the control group patients received placebo. The patients were induced and given muscle relaxant after 5 minutes of starting the drug and intubated after another 3 minutes of bag and mask ventilation. Results: It was found that Dexmedetomidine 1 mcg/Kg during intubation significantly blunted the heart rate, systolic blood pressure, mean arterial pressure and diastolic blood pressure in comparison to placebo. Also the study group showed favorable values of Rate pressure product and Pressure-rate quotient during the intubation and decreased the requirement of Thiopentone for induction. Conclusion: It was concluded that Dexmedetomidine can be added to the drug regime during induction of anaesthesia to blunt the reflex sympathetic response to endotracheal intubation and thus to attenuate the cardiovascular stress.
Authors and Affiliations
Dr Arun Kumar Patra, Dr Shahbaz Hasnain, Dr Ipsita Choudhury
Keywords
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