Comparative study of Dexmedetomidine, Lignocaine and their combination for the attenuation of hemodynamic response during laryngoscopy and intubation

Abstract

The procedure of laryngoscopy and intubation produces short-lived sympathoadrenal response which may be detrimental to high risk patients and sometimes may even be life-threatening. We enrolled 120 patients, ASA I&II, 20-55 year old undergoing elective surgerical procedure under general anesthesia (GA) and they were randomly assigned into 3 equal groups. Group D (Dexmedetomidine), Group L (Lignocaine) and Group DL (Dexmedetomidine plus Lignocaine). Patients were premedicated with routine drugs then Group D- received Dexmedetomidine 1 mcg/kg infusion over 10 mins and Normal saline over 3 mins, Group L- received 10 ml normal saline infusion over 10 mins and Lignocaine 1.5 mg/kg over 3 mins and Group DL- received Dexmedetomidine 0.5 mcg/kg infusion over 10 mins followed by Lignocaine 1 mg/kg over 3 mins and patients were given GA. Vital parameters such as HR, SAP, DAP and MAP were recorded, at baseline, after study drug administration, after induction, 1, 3, 5, 7, 10 and 15 mins after intubation. It was found that the mean HR and BP in group DL remained below baseline value during the entire study period of 15 mins post intubation.It was concluded that the combination of low dose of dexmedetomidine (0.5 mcg/kg) and lignocaine (1mg/kg) effectively attenuates the pressor response during laryngoscopy and intubation without any hemodynamic side effects when compared with Lignocaine (1.5 mg/kg) alone or high dose of Dexmedetomidine (1 mcg/kg) alone.