Author(s): Paritala Subbarao1, Vagdandapu Vijayalakshmi2, Yekula Nirmaladevi3
Laryngoscopy and endotracheal intubation is often associated with hypertension and tachycardia, which can produce deleterious effects in cardiovascular patients. Dexmedetomidine has been particularly effective in blunting the haemodynamic response to laryngoscopy and tracheal intubation in addition to reducing the anaesthetic drug requirements. The present study was undertaken to study the efficacy of 0.6 μg/kg body weight dexmedetomidine IV given 10 minutes before induction in obtunding the haemodynamic responses to laryngoscopy and tracheal intubation compared to control group.
MATERIALS AND METHODS
One hundred normotensive patients aged between 18-55 years belonging to ASA class I and II and Mallampati grade I and II were included and assigned randomly into two groups. Group C (n=50) received 10 mL normal saline intravenously over 10 minutes, 10 minutes before induction and Group D (n=50) received diluted dexmedetomidine intravenously over 10 minutes, 10 minutes before induction. Anaesthesia was induced with Inj. Thiopentone as 2.5% solution till loss of eyelash reflex occurred and dose of thiopentone required was noted followed by Inj. Succinylcholine. HR, SBP, DBP and MAP were recorded at various time intervals.
It was noted that in group C (control), following laryngoscopy and intubation, the rise in Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) were found to be 36.24 bpm, 30.02 mmHg, 22.34 mmHg and 26.42 mmHg respectively, one minute after intubation. In group D (dexmedetomidine), rise of HR, SBP, DBP and MAP were decreased by 2.86 bpm, 15.86 mmHg, 9.54 mmHg and 1.98 mmHg, respectively, which was statistically highly significant (p=0.000). Dexmedetomidine reduced the requirement of thiopentone and vecuronium bromide and produced arousable sedation after extubation.
Dexmedetomidine in the dose of 0.6 μg/kg body weight given intravenously 10 minutes before induction was seen to effectively attenuate the haemodynamic response to laryngoscopy and tracheal intubation without any side effects.