Efficacy of dexmedetomidine in attenuating sympathoadrenal response to laryngoscopy and tracheal intubation.

Abstract

Background: Laryngoscopy and endotracheal intubation under general anesthesia are highly noxious stimuli, whichprovoke marked sympathoadrenal response, with potential catastrophic consequences in patients with cardiovascularand cerebrovascular disease. Many pharmacological agents have been employed to blunt this response. In this studywe investigated the efficacy of dexmedetomidine in attenuating the haemodynamic response to laryngoscopy andtracheal intubation.Patients and methods: Sixty American Society of Anesthesiologists (ASA) grade I/II patients undergoing electivesurgery under general anesthesia were randomly allocated two groups; group D and group C. Group D receivedintravenous dexmedetomidine (1mcg/kg) infusion in 100ml normal saline over 10 minutes and group C received 100mlnormal saline infusion over 10 minutes, prior to induction. Both groups were compared for changes in haemodynamicparameters, sedation scores, and SpO2 at various time intervals following start of infusion, induction and intubation.The qualitative data between the groups were compared using Chi Square test and for comparison of the continuousvariables, independent t- test was used. P<0.05 was considered statistically significant at 95% confidence interval.Results: The two groups had comparable demographic profile. There were no differences in the baseline haemodynamicprofile of the two groups. The mean heart rate, mean systolic, mean and diastolic blood pressures were significantlylower in the patients receiving dexmedetomidine at all time points. However patients receiving dexmedetomidine hadgreater sedation score and lower SpO2 value following infusion.Conclusion: Pre induction dexmedetomidine infusion may effectively attenuate pressor response followinglaryngoscopy and endotracheal intubation.Keywords: Dexmedetomidine, pressor response, laryngoscopy, endotracheal intubation.