2019Indian Journal of Clinical AnaesthesiaOpen access

Attenuation of pressor response to laryngoscopy and intubation: Dexmedetomidine Vs. fentanyl premedication

Ravindra Kumar Gehlot, Lalit Kumar Raiger, L Gokulakrishnan, Madhan Chandramohan, Apoorva Aseri

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Abstract

Introduction: The pressor response during laryngoscopy and intubation is part of a huge spectrum of stress response, results from the increase in sympathetic and sympatho-adrenal activity. The present study was planned to observe the attenuation of pressor response during laryngoscopy and intubation with dexmedetomidine and fentanyl; also to compare the effectiveness between these two drugs. Materials and Methods: In this study we include 128 patients, of ASA grade I- II, aged 18- 65yrs, of either gender, scheduled for elective surgery under general anaesthesia. Groups: Group D – Dexmedetomidine (0.6µg/kg) and Group F – Fentanyl (2µg/kg), these drugs diluted with NS to make 10 ml, given I.V. slow over 10 min. Vital parameters (HR, SBP, DBP and MBP) were recorded as baseline, then at 10 minutes after pre-medication and then at 1,2,3,5,7 and 10 minutes after endotracheal intubation. Results: There was significant increase in heart rate, systolic blood pressure and diastolic blood pressure during laryngoscopy and intubation in group F as compared to group D (p Conclusion: Dexmedetomidine (0.6mcg/kg) is superior to fentanyl (2mcg/kg) in the attenuation of the pressor response and that the ideal time for its administration should be about 10 minutes before a laryngoscopy and intubation. Keywords: Dexmedetomidine, Fentanyl, Intubation, Laryngoscopy, Pressor response.

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Introduction: The pressor response during laryngoscopy and intubation is part of a huge spectrum of stress response, results from the increase in sympathetic and sympatho-adrenal activity. The present study was planned to observe the attenuation of pressor response during laryngoscopy and intubation with dexmedetomidine and fentanyl; also to compare the effectiveness between these two drugs. Materials and Methods: In this study we include 128 patients, of ASA grade I- II, aged 18- 65yrs, of either gender, scheduled for elective surgery under general anaesthesia. Groups: Group D – Dexmedetomidine (0.6µg/kg) and Group F – Fentanyl (2µg/kg), these drugs diluted with NS to make 10 ml, given I.V. slow over 10 min. Vital parameters (HR, SBP, DBP and MBP) were recorded as baseline, then at 10 minutes after pre-medication and then at 1,2,3,5,7 and 10 minutes after endotracheal intubation. Results: There was significant increase in heart rate, systolic blood pressure and diastolic blood pressure during laryngoscopy and intubation in group F as compared to group D (p Conclusion: Dexmedetomidine (0.6mcg/kg) is superior to fentanyl (2mcg/kg) in the attenuation of the pressor response and that the ideal time for its administration should be about 10 minutes before a laryngoscopy and intubation. Keywords: Dexmedetomidine, Fentanyl, Intubation, Laryngoscopy, Pressor response.

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Available abstract

Introduction: The pressor response during laryngoscopy and intubation is part of a huge spectrum of stress response, results from the increase in sympathetic and sympatho-adrenal activity. The present study was planned to observe the attenuation of pressor response during laryngoscopy and intubation with dexmedetomidine and fentanyl; also to compare the effectiveness between these two drugs. Materials and Methods: In this study we include 128 patients, of ASA grade I- II, aged 18- 65yrs, of either gender, scheduled for elective surgery under general anaesthesia. Groups: Group D – Dexmedetomidine (0.6µg/kg) and Group F – Fentanyl (2µg/kg), these drugs diluted with NS to make 10 ml, given I.V. slow over 10 min. Vital parameters (HR, SBP, DBP and MBP) were recorded as baseline, then at 10 minutes after pre-medication and then at 1,2,3,5,7 and 10 minutes after endotracheal intubation. Results: There was significant increase in heart rate, systolic blood pressure and diastolic blood pressure during laryngoscopy and intubation in group F as compared to group D (p Conclusion: Dexmedetomidine (0.6mcg/kg) is superior to fentanyl (2mcg/kg) in the attenuation of the pressor response and that the ideal time for its administration should be about 10 minutes before a laryngoscopy and intubation. Keywords: Dexmedetomidine, Fentanyl, Intubation, Laryngoscopy, Pressor response.

Key concepts: Dexmedetomidine, Laryngoscopy, Anesthesia, Medicine, Fentanyl, Intubation, Premedication, Tracheal intubation

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