Attenuation of Haemodynamic Response to Laryngoscopy and Tracheal Intubation Using Dexmedetomidine,Dexmedetomidine with Fentanyl and Lignocaine

Abstract

Background: As no ideal drug has been found to blunt the stress response, our aim was to study the attenuation of haemodynamic stress response to laryngoscopy and tracheal intubation using Dexmedetomidine, Dexmedetomidine with Fentanyl and Lignocaine. Methods: 60 patients scheduled for various elective surgical procedures were included in the study. The study population was divided randomly into three groups.Group I -D (Dexmedetomidine group) 20 patients will receive IV Dexmedetomidine 1µm/Kg in 100 ml NS infused over 10-15 minutes before induction.Group II -DF (Dexmedetomidine with fentanyl group) 20 patients received IV Dexmedetomidine 1µgm/Kg combined with Fentanyl 1µgm/Kg in 100 ml NS infused over 10-15 minutes before induction. Group III -L (Lignocaine group) 20 patients received IV bolus lignocaine 1.5mg/Kg 90 seconds before intubation. All the patients were premedicated with injection glycopyrrolate 0.2mg, injection Ondansetron 4mg, injection Tramadol 2mg/kg and injection Midazolam 0.05mg/kg given slowly IV 15 minutes before induction. The HR, SBP, DBP, MAP was recorded at 1, 3, 5 minutes after intubation. In Group LLignocaine could not blunt the intubation response until 3 or 5 minutes after intubation. Results: In Group D, Dexmedetomidine showed marked decrease in hemodynamic response but the attenuation was highly significant in Group DF (Dexmedetomidine with Fentanyl) throughout the study period. Conclusion: IV Dexmedetomidine in the dose of 1µg/kg with Fentanyl 1µg/kg given 15 minutes before induction as infusion effectively attenuated the pressor response during Laryngoscopy and Intubation without any deleterious side effects.