Evaluation and comparison of clonidine and dexmedetomidine for attenuation of hemodynamic response to laryngoscopy and intubation: A randomized controlled study

Hussain, Syed Fayyaz; Karmarkar, Abhijit A; Jain, Dhruv

doi:10.4103/aer.aer_123_18

Cited by 12 publications

(4 citation statements)

References 22 publications

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“…This leads to blunting of sympathetic discharge, and thus it stabilizes hemodynamics during laryngoscopy and intubation. 15 In addition to its use as intravenous route. 16 Dexmedetomidine has also been used as nebulization to prevent hemodynamic response to laryngoscopy.…”

Section: Discussionmentioning

confidence: 99%

Prevention of Pressor response to Laryngoscopy: A Comparison of Lignocaine with Dexmedetomidine

Shahid,

Maqbool,

Shabbir

et al. 2023

J. Bahria Uni. Med. Dent. Coll.

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Objective: To compare intravenous Lignocaine with Dexmedetomidine for prevention of pressor response to laryngoscopy. Study design and setting: Randomized Clinical Trial at Anesthesia Department, RIHS Islamabad. (1st May2019 To 30th October 2019) Methodology: 68 patients with age 20-60 years, ASA status(I or II), planned for elective surgeries under GA were included in this study and randomly divided into groups A and B by lottery method. Patients with history of hypertension, heart blocks, beta-blockers were excluded from study. Group-A patients were given injection Lignocaine 2% 1mg/kg 1min before induction and Group-B patients were given injection Dexmedetomidine 1ug/kg 15 min before induction of anesthesia. After premedication with injection Midazolam, Nalbuphine, and Ondansetron, Induction of anesthesia was done with injection Propofol and Cisatracurium. Patients were intubated. Use of stylet,BURP maneuver, incidence of laryngospasm was noted. Vitals before and after intubation were noted. Results: There was no significant difference in demographic profile,use of a stylet, BURP maneuver and laryngospasm in both groups. ANOVA test shows significant decrease in change in Systolic BP in Dexmedetomidine group at 2 and 3 minutes after intubation as compared to Lignocaine group however Diastolic BP and Heart rate was comparable in both groups. Paired t test showed a significant decrease in Systolic and Diastolic BP in both groups( more in Dexmedetomidine group).Regarding heart rate paired t test showed insignificant difference in Lignocaine group and significant difference in Dexmedetomidine group. Conclusion: Intravenous Dexmedetomidine is superior to Lignocaine to prevent pressor response to laryngoscopy

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Section: Discussionmentioning

confidence: 99%

Prevention of Pressor response to Laryngoscopy: A Comparison of Lignocaine with Dexmedetomidine

Shahid,

Maqbool,

Shabbir

et al. 2023

J. Bahria Uni. Med. Dent. Coll.

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“…Previous medications, such as lidocaine, propofol, esmolol, and clonidine, have not been entirely effective due to their numerous disadvantages (18). Several techniques have been used to control hemodynamic response to stabilize HR and MAP during laryngoscopy and preserve the perfusion of the vital organs (19).…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine vs. Fentanyl-Midazolam Combination to Mitigate the Stress Response in Microlaryngoscopy: A Randomized Double-blind Clinical Trial

Oriby,

Elrashidy,

Khafagy

et al. 2023

Anesth Pain Med

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Background: Laryngoscopy is the most painful noxious stimulus during anesthesia and surgery. Dexmedetomidine is increasingly used as a sedative in surgeries involving microlaryngoscopy. Objectives: This study aimed to evaluate the effect of dexmedetomidine and a combination of fentanyl and midazolam on mitigating the stress response in patients scheduled for microlaryngoscopy. Methods: This randomized, double-blind clinical trial enrolled 60 patients (28 males and 32 females) aged 18 - 65 years with the American Society of Anesthesiologists (ASA) physical status I - III. The patients were scheduled for microlaryngoscopy and equally divided into 2 groups. Group D received 1 μg/kg of dexmedetomidine and saline bolus dose over 10 minutes before general anesthesia (GA) induction, followed by 0.5 μg/kg/h of dexmedetomidine and saline infusions after GA induction. Group MF received 0.8 μg/kg of fentanyl plus 0.05 mg/kg of midazolam over 10 minutes before GA induction, followed by 1 μg/kg/h of fentanyl plus 0.05 mg/kg/h of midazolam as an infusion. The heart rate (HR) and mean arterial blood pressure (MAP) pressure were recorded from baseline until the end of surgery. Infusions were stopped at the end of the surgery. Results: The number of patients requiring propofol and intraoperative supplemental propofol was significantly lower in group D than in group MF. The heart rate was significantly lower in group D than in group MF (P = 0.022, 0.048, 0.032, 0.045, 0.041, 0.026, 0.030, and 0.036) from induction until the end of surgery; in addition, it was comparable between both groups at baseline and before induction. MAP was comparable between both groups for all measurements. Conclusions: Dexmedetomidine mitigates the hemodynamic changes related to microlaryngoscopy more effectively than the fentanyl-midazolam combination.

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“…Investigators have used various techniques and different drugs regimens with varied levels of success to attenuate the stress response such as topical lignocaine spray, a deep plane of anesthesia, limiting the duration of laryngoscopy within 15 seconds, intravenous opioids [5][6][7] , calcium channel blockers, vasodilators, lignocaineand beta-blocker [8][9][10][11][12] . Besides different doses [7][8][9] , it has also been compared with fentanyl [5][6] , esmolol [11][12] sufentanil 7 remifentanil 13 clonidine 14 .…”

Section: Introductionmentioning

confidence: 99%

Role of Dexmedetomidine in Attenuation of Hemodynamic Response to Laryngoscopy - A Dose-Finding Study

SM,,

M,,

et al. 2023

PJMHS

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Aim: Determining efficacy of pre-operative bolus dose of dexmedetomidine 0.75 and 0.5µg/kg as an infusion and compare it with placebo in attenuation of hemodynamic response to laryngoscopy and tracheal intubation (LTI). Design: Double-blind randomized control. Place & duration: Sindh Institute of Urology & Transplantation, Karachi, Pakistan, from August 2019 to August 2021. Methodology: Patients were stratified into three groups. Group A received normal saline (NS), Group B received dexmedetomidine 0.5 μ/kg and Group C received dexmedetomidine 0.75 μ/kg as an infusion over 10 minutes followed by standardized general anaesthesia. Primary outcome measures were hemodynamic variables at 1, 3, 5 and 10 minutes post LTI. Secondary outcome measures were adverse effects related to dexmedetomidine. Results: Both dexmedetomidine groups showed better attenuation of hemodynamic response to LTI thansaline group. Dexmedetomidine 0.75 µg/kg attenuated hemodynamic response to LTIsignificantly better thandexmedetomidine 0.5 μ/kgand placebo without causing any statistically significant adverse effects. Practical implication: The function of dexmedetomidine in attenuating hemodynamic response to laryngoscopy has several practical implications, including improved patient safety, optimal dosing, reduced anaesthetic requirements, cost-effective treatment, and enhanced patient comfort. Conclusion: Dexmedetomidine 0.75 µg/kg efficient than 0.5 µg/kg and placebo in attenuating hemodynamic response to LTI when given as a pre-induction bolus. Keywords: Anesthesia; Dexmedetomidine, Laryngoscopy, Intubation, Stress Response.

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Evaluation and comparison of clonidine and dexmedetomidine for attenuation of hemodynamic response to laryngoscopy and intubation: A randomized controlled study

Cited by 12 publications

References 22 publications

Prevention of Pressor response to Laryngoscopy: A Comparison of Lignocaine with Dexmedetomidine

Prevention of Pressor response to Laryngoscopy: A Comparison of Lignocaine with Dexmedetomidine

Dexmedetomidine vs. Fentanyl-Midazolam Combination to Mitigate the Stress Response in Microlaryngoscopy: A Randomized Double-blind Clinical Trial

Role of Dexmedetomidine in Attenuation of Hemodynamic Response to Laryngoscopy - A Dose-Finding Study

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