Hemodynamic Response During Laryngoscopy and Endotracheal Intubation With or Without Low Dose Dexmedetomidine Premedication : An Observational Study

Abstract

Introduction: Laryngoscopy and endotracheal intubation are important airway securing techniques for patients undergoing general anaesthesia in operating room. This procedure is associated with significant hemodynamic changes putting undue stress in the heart and the brain circulation . Multiple drug therapies have been used to attenuate these responses, but none have been entirely successful till date. Hence aim of the study is to evaluate effects of single, low dose dexmedetomidine premedication on hemodynamic stress response during laryngoscopy and endotracheal intubation in patient posted for elective surgeries under general anaesthesia requiring endotracheal intubation.

Methodology: A prospective, observational study conducted in Bir Hospital and National Trauma Center after approval from Institutional Review Board with enrollment of 52 patients of American Society of Anesthesiologists Physical Status I and II divided into two equal groups. Dexmedetomidine group received 0.5 microgram per kilogram premedication infusion over 10 minutes. Haemodynamic parameters (heart rate and blood pressures) at baseline, after induction, just before intubation, 1, 3, 5 and 10 minutes after intubation were recorded. The general anaesthesia technique was standarized for both groups. p-value < 0.05 was considered statistically significant.

Results: Demographic data were comparable. Statistically significant decrease (p < 0.05) in heart rate, systolic, diastolic, and mean arterial pressures in dexmedetomidine group. None of the patients in dexmedetomidine group had hypotension, bradycardia hypertension and tachycardia.

Conclusion: Dexmedetomidine premedication with 0.5 μg/kg is better for attenuating stress response due to laryngoscopy and endotracheal intubation.