Author(s): Ravindra Channagiri Gangappa1, Kavi Chandrashekharappa2, Kiran Mallappa3
Direct laryngoscopy and endotracheal intubation are the most stressful periods during induction of anaesthesia. These events can lead to hypertension, tachycardia, arrhythmias and myocardial ischaemia. Dexmedetomidine, an alpha-2 adrenoreceptor agonist, is gaining popularity for its sympatholytic, sedative, anaesthetic sparing and haemodynamic stabilising properties without significant respiratory depression.
The aim of the study is to compare the efficacy of Dexmedetomidine against Lignocaine in attenuation of haemodynamic response of laryngoscopy and endotracheal intubation.
A randomised controlled study was designed with total of 60 patients of which 30 patients received dexmedetomidine (Group D) 1 mcg/kg IV infusion 10 minutes prior to endotracheal intubation and 30 patients received 1.5 mg/kg of lignocaine intravenous (Group L) 3 mins. prior to endotracheal intubation. Inj. Thiopentone was given until eyelash reflex disappeared and intubation was facilitated with succinylcholine. Anaesthesia was maintained with 33:66 Oxygen: Nitrous oxide, halothane, and vecuronium. The patients were evaluated for change in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) & heart rate (HR) during pre-induction, just prior to induction at 0,1,3,5 & 10 mins. after laryngoscopy & intubation. Any adverse effects of the drugs were noted.
The two groups were comparable regarding age, sex, weight and type of surgeries. The HR, SBP, DBP, and MAP values were significantly lower in Group D at induction and statistically lower at 1, 3, 5, and 10 mins. when compared to Group L.
Dexmedetomidine attenuates the haemodynamic stress response to laryngoscopy and intubation more effectively when compared with lignocaine without any adverse effects.