Affiliation:
1. Department of Anaesthesia, GMC Jammu
Abstract
Background and objectives: Laryngoscopy and intubation is associated with a sympathetic response
that results in a rapid increase in blood pressure and heart rate. The mechanisms underlying these
hemodynamic changes are incompletely understood. They may be caused by a reex sympathetic discharge due to
stimulation of the upper respiratory tract. It has been observed that hemodynamic responses to tracheal intubation are
associated with an increase in plasma catecholamine concentrations and are attenuated by β-adrenergic blockade. This study
was conducted to compare the efcacy of dexmedetomidine and fentanyl for attenuation of pressor response during
laryngoscopy and intubation. Materials and methods Following approval by ethical committee, 60 ASA grade I and II patients
of either sex undergoing general anaesthesia for elective surgery were included in this study. Patients were randomly divided
into two groups of 30 patients each. Dexmedetomidine in a dose of 1μg/kg i.v was given to Group A patients and Fentanyl 2
μg/kg i.v was given to Group B patients. Both the drugs were diluted with normal saline solution to make 10ml and were
administered slow intravenous 10 min before induction. The hemodynamic parameters were recorded, demographic data was
analyzed using unpaired t-test and hemodynamic variables were analyzed by using unpaired and paired t-test. Side effects
were analyzed using chi square test. Result: The two groups were comparable in their demographic proles.
Dexmedetomidine proved itself to be an excellent drug when given intravenously in dose of 1μg/kg to attenuate hemodynamic
response to laryngoscopy and intubation. It blunted the hemodynamic response to laryngoscopy and intubation to a greater
magnitude than fentanyl in a dose of 2μg/kg intravenously as a premedication. Conclusion: We conclude that fentanyl 2μg/kg
i.v. given ten minutes prior to airway instrumentation shows an inconsistent response to laryngoscopy and intubation. Between
the two drugs under study, the use of dexmedetomidine 1μg/kg i.v. is satisfactory and produces a more favorable hemodynamic
prole while fentanyl 2μg/kg is found to be non- dependable and less effective for the attenuation of the pressor response to
laryngoscopy and endotracheal intubation.
Subject
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