BACKGROUNDUpper Lip Bite Test (ULBT) has been evaluated as a simple bedside test to predict the grade of laryngeal visualisation. As the utility of this test is not yet evaluated in patients from this geographical location of India, we intend to investigate whether the combination of the ULBT classification with Sternomental Distance (SMD), Thyromental Distance (TMD), and Inter-Incisor Distance (IID) to predict easy laryngoscopy and compared with each test alone.
INTRODUCTIONMany pharmacological agents have been evaluated in regards to their efficacy of blunting the adverse cardiovascular response to laryngoscopy and tracheal intubation. The aim of this study was to evaluate the efficacy of dexmedetomidine compared to fentanyl in blunting the haemodynamic response to laryngoscopy and intubation.
METHODSixty patients were randomly allocated into two groups (30 patients in each group). The group D received intravenously 1 µgm/kg dexmedetomidine infusion and group F received 2µgm/kg fentanyl infusion. The study drugs were prepared in an identical looking container and were infused fifteen minutes prior to induction of anaesthesia. The study drugs were infused over a period of ten minutes and all the patients underwent a similar anaesthetics technique. Heart rate (HR) and blood pressure (systolic, diastolic and mean blood pressure) were noted at baseline, at the end of infusion of the study drugs, after induction of anaesthesia, immediately after laryngoscopy and intubation and at 1, 3, 5, 7 and 10 minutes after laryngoscopy and intubation.
RESULTSHR significantly decreased in the group D when compared to group F immediately after study drug infusion and there was statistically significant reduction in heart rate for up to 5 min after intubation in both the groups. Although HR increased after intubation in both the groups, the magnitude was lower in the group D. In both the groups, laryngoscopy and intubation led to an increase in systolic, diastolic and mean arterial pressure; the magnitude was lower in the group D.
CONCLUSIONDexmeditomidine (1µ/kg) attenuates these untoward responses of laryngoscopy and intubation more effectively than fentanyl (2 µ/kg) when administered as bolus dose in the pre-induction period of general anaesthesia.
HOW TO CITE THIS ARTICLE:Konwar C, Barman P, Saikia P et al. Effects of preanesthetic single dose intravenous dexmedetomidine versus fentanyl on hemodynamic response to endotracheal intubation-a clinical comparative study.
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