Intravenous dexmedetomidine 1µg/kg as premedication to attenuate hemodynamic response to laryngoscopy and endotracheal intubation in surgeries under general anesthesia (original) (raw)
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2016
Introduction: The process of Laryngoscopy and intubation are deleterious stimuli which causes a period of haemodynamic stress and is related with extreme sympathetic activity marked by increased in heart rate and blood pressure. The aim of the study was to evaluate and compare the efficacy of single premedication dose of dexmedetomidine 01micro gram/kg i/v in attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation. Material and Methods: After institutional ethical committee clearance, 120 patients between the age group of 20 and 50 years, belonging to ASA class 1 and 2, and scheduled for general surgeries under general anaesthesia, were randomized into groups-D and N, having 60 patients each. Groups-D and N were premedicated with Inj.dexmedetomidine and 0.9% Normal saline respectively and their haemodynamic parameters measured before and after intubation and thereafter, at regular intervals noted. Any intra operative adverse effects were noted. Results: No ...
Indian journal of anaesthesia, 2017
Laryngoscopic manipulation and endotracheal intubation are noxious stimuli capable of producing tachycardia, arrhythmias and hypertension. The aim of this study was to arrive at an optimal dose of dexmedetomidine by comparing two doses with placebo to attenuate stress response during laryngoscopy and endotracheal intubation. It was a randomised, prospective, double-blind placebo-controlled study. After Institutional Ethical Committee clearance, ninety patients of American Society of Anesthesiologists Physical Status 1 were enrolled in the study and divided into three equal groups. Group A received normal saline, Group B received injection dexmedetomidine 0.5 μg/kg and Group C received injection dexmedetomidine 0.75 μg/kg as infusion over 10 min. The general anaesthesia technique was standardised for all three groups. The primary outcome measures were haemodynamic response at 1, 3 and 5 min after intubation. The secondary outcome measures were to note down any adverse effects associa...
Journal of Evidence Based Medicine and Healthcare, 2016
Direct laryngoscopy and endotracheal intubation are the most stressful periods during induction of anaesthesia. These events can lead to hypertension, tachycardia, arrhythmias and myocardial ischaemia. Dexmedetomidine, an alpha-2 adrenoreceptor agonist, is gaining popularity for its sympatholytic, sedative, anaesthetic sparing and haemodynamic stabilising properties without significant respiratory depression. AIM The aim of the study is to compare the efficacy of Dexmedetomidine against Lignocaine in attenuation of haemodynamic response of laryngoscopy and endotracheal intubation. METHODS A randomised controlled study was designed with total of 60 patients of which 30 patients received dexmedetomidine (Group D) 1 mcg/kg IV infusion 10 minutes prior to endotracheal intubation and 30 patients received 1.5 mg/kg of lignocaine intravenous (Group L) 3 mins. prior to endotracheal intubation. Inj. Thiopentone was given until eyelash reflex disappeared and intubation was facilitated with succinylcholine. Anaesthesia was maintained with 33:66 Oxygen: Nitrous oxide, halothane, and vecuronium. The patients were evaluated for change in systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP) & heart rate (HR) during pre-induction, just prior to induction at 0,1,3,5 & 10 mins. after laryngoscopy & intubation. Any adverse effects of the drugs were noted. RESULTS The two groups were comparable regarding age, sex, weight and type of surgeries. The HR, SBP, DBP, and MAP values were significantly lower in Group D at induction and statistically lower at 1, 3, 5, and 10 mins. when compared to Group L. CONCLUSION Dexmedetomidine attenuates the haemodynamic stress response to laryngoscopy and intubation more effectively when compared with lignocaine without any adverse effects.
Asian Journal of Pharmaceutical and Clinical Research, 2017
INTRODUCTION: The airway instrumentation of direct laryngoscopy and tracheal intubation are powerful noxious stimuli that should be attenuated by appropriate premedication, smooth induction and rapid intubation. The present study compared the efficacy intravenous dexmedetomidine and oral pregabalin premedication for attenuation of haemodynamic pressor response to laryngoscopy and intubation.METHODS: A total of 60 patients of age group 20-50 years scheduled for elective surgeries under general anaesthesia with ASA physical status I and II were divided into two groups each of 30. Group D received intravenous dexmedetomidine 1mcg/kg over 10 minutes before induction and group P received oral pregabalin 150 mg one hour prior to intubation. Parameters observed were heartrate and mean arterial pressure at baseline, after induction, immediately after intubation and then 5, 10, 15 and 30 minutes thereafter.RESULTS: Attenuation of heartrate in group dexmedetomidine (78.12 ± 10.0 / min) im...
National Journal of Medical Research, 2015
Background: Laryngoscopy and intubation is the Gold standard for airway management but this evokes a stress response which is exhibited in the form of changes in heart rate, blood pressure and arrhythmias. This study was prospective, randomized, double blind study to determine whether the fentanyl 2µg/Kg or dexmedetomidine 1µg/Kg would decrease the attenuation of hemodynamic response during laryngoscopy and tracheal intubation during general anaesthesia. Methodology: The patients were randomly allocated into two groups. In Group D cases (n=30) received injection Dexmedetomidine 1µg/kg diluted to 10ml NS IV over 10min using syringe pump prior to intubation and 5ml of NS 5 min. prior to intubation. In Group F cases (n=30) received 2µg/kg diluted to 5ml NS 5min. prior to intubation and 20ml NS in infusion pump over 10 min., prior to intubation. Results: The age and weight of the cases in both the groups are comparable. It was observed that mean HR increased in both groups D and F immediately after endotracheal intubation. The systolic blood pressure was highly significant in group F as compared to group D during laryngoscopy and intubation, 1, 3, 5 and 10 min after intubation (p<0.000). Ramsay sedation score was ≥ 4 in all patients in group D and was ≤ 3 in group F. Dexmedetomidine has higher sedation score but no respiratory depression. Conclusion: We concluded that dexmedetomidine in dose 1µgm/kg i.v. is more effective in attenuating the hemodynamic pressor responses to laryngoscopy and intubation than Inj. Fentanyl 2µgm/kg i.v. when given as pre-medicant without significant side effects.
Indian Journal of Forensic Medicine & Toxicology, 2021
Background: Laryngoscopy and endotracheal intubation alters cardiovascular physiology causinghypertension and tachycardia. Dexmedetomidine, an alpha 2 adrenergic receptor produces analgesiaby direct activation of descending inhibitory pain pathway and inhibiting the release of substance P.Clonidine a centrally acting alpha 2 adrenergic agonist decreases central sympathetic nervous system in allhyperadrenergic situations. Hence we compare haemodynamic effects between dexmedetomidine 0.5 mcg/kg and clonidine 1mcg/kg during after laryngoscopy and tracheal intubation for patients undergoing generalanaesthesia.Method: Patients were allocated randomly into 2 groups of 30 each. Group D received dexmedetomidine0.5mcg/kg diluted in 10ml NS and group C- clonidine 1 mcg/kg diluted in 10ml NS intravenously andhemodynamic parameters were observed. Dexmedetomidine/ Clonidine according to groups is givenintravenously with premedication. After 5 minutes patients were induced with 2.5% thiopentone 5...
Journal of Evidence Based Medicine and Healthcare
BACKGROUND We wanted to study the attenuation of haemodynamic stress responses during laryngoscopy and intubation using safe and effective dose of dexmedetomidine. METHODS In this prospective double-blind placebo control interventional study, 120 patients of ASA-I and ASA-II scheduled for elective surgeries under general anaesthesia were divided randomly into four equal groups. Group A, group B, and group C received 0.5 mcg / Kg, 0.75 mcg / Kg and 1 mcg / Kg of dexmedetomidine intra venous (IV) respectively and Group D received 10 mL normal saline (NS) IV as bolus prior to induction of anaesthesia. Haemodynamic parameters were recorded before administration of the study drug, at 5 min with ongoing infusion of study drug, after completion of the study drug (at 10 min.), immediately after induction, during intubation, every minute thereafter up to 5 mins then 10 min after intubation. Data was analysed using SPSS. RESULTS Groups were well matched for their demographic data. There was a...
International Journal of Basic & Clinical Pharmacology, 2014
Background: Laryngoscopy and tracheal intubation after the induction of anesthesia are nearly always associated with a sympathetic hyperactivity. To attenuate the pressor response, various drugs have been tried, but studies to compare the effects of dexmedetomidine or clonidine on the hemodynamic response during laryngoscopy and tracheal intubation are anecdotal and sparse. This study aims to fi nd the drug, which was best suited for this purpose and to compare their effects on sedation and anesthetic requirements. Methods: This was a prospective study, which involved three groups of patients. Each group had 20 patients who presented for elective, non-cardiovascular surgeries. The patients in group I (control) were given normal saline and the groups II and III were given dexmedetomidine and clonidine, respectively. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and Ramsay sedation score were recorded at 1 and 2 min after completion of administration of study drug. Induction was done with propofol and required dose is noted. HR, SBP, and DBP were again assessed during intubation and at 1, 3, 5, and 10 min after intubation. The obtained clinical data were analyzed statistically with analysis of variance. Results: In our study, HR, SBP, and DBP all increased during intubation and thereafter in all three groups. Pretreatment with dexmedetomidine 1 μg/kg and clonidine 2 μg/kg signifi cantly attenuated the cardiovascular and catecholamine responses to tracheal intubation. However, attenuation was signifi cantly more with the dexmedetomidine group with a quicker return to baseline. Dexmedetomidine also fared in terms of anesthetic requirement (propofol) and sedative action. Conclusion: Preoperative administration of a single dose of dexmedetomidine blunted the hemodynamic responses more than clonidine or placebo during laryngoscopy, and reduced anesthetic requirements.
Asian Journal of Medical Sciences, 2022
Background: Many drugs used to reduce the hemodynamic stress response during laryngoscopy and endotracheal intubation. The quest for ideal drugs and their dosage without major side effects is still pursued. Dexmedetomidine, an alpha-2 agonist, is emerging as a promising drug to counteract the catecholamine release. Aims and Objectives: This study is done to compare the effect of lower doses dexmedetomidine and esmolol in control of hemodynamic response and stability in cases undergoing laryngoscopy and endotracheal intubation during general anesthesia.Setting and Design: This was a prospective, randomized double-blinded comparative study. Materials and Methods: After approved by the Institute Ethics Committee, consent obtained from 60 patients (n=60) belonging to ASA I or II. Patients were equally divided into twogroups (D and E). Group D patients (n=30) were infused with intravenous dexmedetomidine at 0.75 mcg/kg diluted in 20 ml with normal saline 10 min before induction. Group E ...
Journal of evolution of medical and dental sciences, 2018
BACKGROUND Laryngoscopy and tracheal intubation after the induction of anaesthesia are nearly always associated with a sympathetic hyperactivity. To attenuate the pressor response various drugs have been tried, but these drugs were either partially effective or they produced undesirable effects. This study aims to compare the effects of Dexmedetomidine (0.5 µg/kg) and Clonidine (0.5 µg/kg) on haemodynamic responses to endotracheal intubation, effect on anaesthetic requirements and effect on sedation. MATERIALS AND METHODS In this prospective, randomised, clinical trial, 100 patients of either sex, aged 20-60 years of ASA grade I and II scheduled for elective surgeries under general anaesthesia were randomly divided into two groups Group D (Inj. Dexmedetomidine dose 0.5 μg/kg IV in 100 mL normal saline) and Group C (Inj. Clonidine dose 0.5 μg/kg IV in 100 mL normal saline). Haemodynamic parameters (HR, SBP, DBP, MAP, SpO2) were monitored continuously and recorded before the start of infusion, at the start of infusion, at 5 mins of start of infusion, at 10 mins of start of infusion, at intubation and then at 1, 3, 5 and 10 minutes after intubation. RESULTS Magnitude of increase in heart rate at intubation and 1 min after intubation was higher in Group C as compared to Group D and this was statistically significant. Group C had significant rise in SBP and DBP during intubation and at 1, 3, 5 and 10 mins after intubation as compared to Group D. Significant reduction in dose is required for induction in Group D than in Group C. CONCLUSION Dexmedetomidine significantly attenuated the sympathetic response of laryngoscopy and intubation as compared to clonidine.