An evaluation of efficacy of addition of dexmedetomidine /clonidine to fentanyl in attenuation of pressor response of laryngoscopy and intubation: A prospective double blind randomized controlled trial

Abstract

Laryngoscopy and intubation have been associated with increased sympathetic responses such as hypertension, tachycardia, arrhythmias, and myocardial infarction. This response is usually transient and variable but might be life threatening in cardiovascular and cerebrovascular compromised patients. So controlling this response is utmost goal of anaesthesia. We evaluated the effectiveness of dexemedetomidine/clonidine to attenuate pressor response.Evaluation of efficacy of addition of Dexemedetomidine/ clonidine to fentanyl in attenuation of pressor response of laryngoscopy and intubation.96 patients were enrolled and randomly divided in three groups having 32 patients each. Group NS received 10 ml normal saline, Group CL received 2mcg/kg Inj. Clonidine and Group DE received 1mcg/kg Inj. Dexemedetomidine infusion over 10 min before laryngoscopy. Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were studied immediately after premedication, 10 min after study drug infusion and then at 1, 2,3,4,5 and 10 min intervals. : There was significant fall in mean HR and mean MAP after 10 min of study drug infusion. Clonidine and dexemedetomidine groups had significantly less rise in heart rate and mean arterial pressure after intubation and then at 1,2,3,4,5 and 10 min time intervals compared to placebo group. No significant side effects were observed.: Use of dexemedetomidine 10 min before laryngoscopy was associated with significantly less rise in pressor response compared to placebo group. Dexemedetomidine better attenuates the pressor response compared to clonidine but the difference was statistically insignificant.