Title: Comparison of Efficacy of Dexmedetomidine versus Lignocaine in Attenuation of hemodynamic response to laryngoscopy and intubation

Authors: Dr Tanushree Vijay, Dr Kavyashree H S

 DOI: https://dx.doi.org/10.18535/jmscr/v8i3.15

Abstract

   

Background: The present study is to compare the efficacy of dexmedetomidine versus Lignocaine to attenuate hemodynamic response occurring due to laryngoscopy and endotracheal intubation in elective general surgery.

Methods: A total of 60 patients aged 18-60 years, American Society of Anesthesiologists physical status I or II, either sex, scheduled for elective surgical procedures were included in this study. Patients were randomly using a computer generated random number table to  two equal groups of 30 each, comprising of group dexmedetomidine (group D) 1 μg/kg diluted with 0.9% saline to 10 ml I.V. over 10min and group  (L) 1.5 mg/Kg of Lignocaine diluted with 0.9% saline  10 ml I.V. given just before induction. Heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were recorded at baseline, after 3 min of infusion, after induction and at 1, 3, 5 and 10 min after endotracheal intubation.

Results: In group D, there was no statistically significant increase in HR and blood pressure after intubation at any time intervals, where as in group L, there was a statistically significant increase in blood pressure and heart rate after intubation at 1, 3, 5 and 10 min.

Conclusions: Dexmedetomidine 1 μg/kg is more effective  in attenuating the hemodynamic response to laryngoscopy and intubation than Lignocaine 1.5 mg/Kg in elective surgical patients.

Keywords: Dexmedetomidine, Lignocaine, hemodynamic response, laryngoscopy.

References

  1. Miller R, editor. Airway management. In: Miller’s Anesthesia. VIIIth ed. Philadelphia: Churchill Livingstone; 2019. p. 1647-8.
  2. Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation. Br J Anaesth, 1987;59:295-9
  3. Grewal A. Dexmedetomidine: new avenues. J Anaesthesiol Clin Pharmacol. 2011;27:297-302.
  4. Gupta HB et al. Int J Basic Clin Pharmacol. 2016 Oct;5(5):1803-1808
  5. Bajwa SS, Kaur J, Singh A, Parmar SS, Singh G, Kulshrestha A, et al. Attenuation of pressor response and dose sparing of opioids and anaesthetics with pre-operative dexmedetomidine. Indian J Anaesth. 2012;56:123-8.
  6. Keniya VM, Ladi S, Naphade R. Dexmedetomidine attenuates sympathoadrenal response to tracheal intubation and reduces perioperative anaesthetic requirement. Indian J Anaesth. 2011;55:352-7.

Corresponding Author

Dr Tanushree V

Junior Resident, Department of General Medicine, Sri Siddhartha Medical College Hospital & Research Centre, Tumakuru, Karnataka, India