Effect of dexmedetomidine by nebulizer for blunting stress response to direct laryngoscopy and intubation

Abstract

Introduction: Direct laryngoscopy and intubation are noxious stimuli and are associated with transient, unpredictable and variable hemodynamic changes. Dexmedetomidine has the potential to produce bradycardia and hypotension when administered as a bolus; in a way to solve this problem, nebulization route chosen. Nebulized dexmedetomidine has a bioavailability of 65%. Nebulized drug preferred over intranasal administration to avoids adverse effects. Aim and Objectives: The aim of this study to evaluate the role of nebulized dexmedetomidine as a premedication in attenuating the stress response to laryngoscopy and intubation along with any adverse effects of drug. Materials and Methods: 50 patients of ASA grade I and II elective surgery undergoing general anesthesia were randomly divided in two groups N and D, who received nebulized normal saline(5ml) and nebulized dexmedetomidine (1ug/kg diluted in 5ml NS) respectively with a nebulizer face mask for 10 min before induction of anesthesia in sitting position.Result: Following laryngoscopy and intubation, stress response markedly increased in the group N where stress response markedly decreases in group D.Conclusions: Nebulized dexmedetomidine effectively blunts the stress response to laryngoscopy and intubation with no adverse effects.