An evaluation of haemodynamic responses to tracheal intubation following intravenous dexmedetomidine and fentanyl in patients undergoing laparoscopic cholecystectomy

Abstract

Background: Laryngoscopy and tracheal intubation are related to sympathetic stimulation and lead to
hypertension and tachycardia. These changes in hemodynamics may increase the risk of myocardial ischemia. As a
result, effective blunting of these unpleasant responses is required. This study aimed to compare the effects of
dexmedetomidine and fentanyl bolus administration on the attenuation of hemodynamic response to tracheal intubation
in patients undergoing laparoscopic cholecystectomy surgeries.
Methodology: A total of 136 patients of both genders undergoing elective laparoscopic cholecystectomy surgeries
satisfying inclusion criteria were randomly allocated into 2 groups (group D and group F). Group D received
1mcg/Kg of dexmedetomidine (Dexa) intravenous (IV) in 100ml of normal saline over 10 minutes and 5ml of
normal saline over 3 minutes before induction. Group F received Inj. Fentanyl 2mcg/Kg diluted in 100 ml of
normal saline over 10 minutes and 5ml of normal saline 3 minutes before induction. The patients were ventilated
for 3 minutes by bag and mask. After 3 minutes of ventilation, endotracheal intubation was done. Vitals (systolic
blood pressure, diastolic blood pressure, mean arterial blood pressure, heart rate) were recorded from the time of
intubation to 10 minutes after that at 1-minute intervals.
Results: In both groups, heart rate increased significantly immediately following intubation (p = 0.002). In
dexmedetomidine group heart rate, mean arterial pressure, systolic and diastolic blood pressures were significantly
controlled at various time points in comparison to the fentanyl group after laryngoscopy and intubation.
Conclusions: Dexmedetomidine in a dose of 1mcg/kg causes greater and sustained attenuation of haemodynamic
response to endotracheal intubation among the patients of cholelithiasis undergoing laparoscopic cholecystectomy
surgeries as compared to fentanyl. Therefore, it can be used as an effective alternative to opioids for the induction of
general anaesthesia in patients undergoing laparoscopic cholecystectomy surgery.