Efficacy of intravenous dexmedetomidine for attenuation of hemodynamic stress response to laryngoscopy and intubation

Abstract

Background: Hemodynamic variation during laryngoscopy and tracheal intubation with reflex increase in sympathetic and sympathoadrenal activity is always matter of major concern for anesthesiologist, which may result in catastrophic effect, such as tachycardia, hypertension, myocardial ischemia, cardiac arrhythmia or cerebrovascular accident. To attunate haemodynamic response various drug such as lignocaine, opioids, nitroprusside, nitroglycerine, verapamil, nifedipine, esmolol has been used. Αlpha-2 adrenergic agonist decrease sympathetic tone and obtunding hemodynamic response to noxious stimulation and prevent overall hemodynamic variability. Aims and objectives: To study the efficacy of iv dexmedetomidine for attenuating stress responses to laryngoscopy and intubation.Materials and Methods: Eighty patients, ASA grade I/II, undergoing routine general anesthesia were randomly premedicated by i.v. dexmedetomidine (1µg/kg in 50 cc NS) or saline via infusion pump over 10 min. Heart rate (HR), mean arterial pressure (MAP) were measured before, after the premedication, after propofol, after succinylcholine, at laryngoscopy, immediately after intubation and then 1 min, 3 min and 5 min after intubation. Results: The demographic data was comparable in both groups. After intubation the increase in heart rate was more in group C than group D (p