To evaluate two different doses of Dexmedetomidine for attenuating the hemodynamic response to tracheal intubation
Keywords:Dexmedetomidine, Endotracheal intubation, Hypertension
Introduction: The hemodynamic response associated with laryngoscopy and tracheal intubation is a common concern for the anesthesiologist, especially in high-risk patients. The use of dexmedetomidine has found favor in obtunding this response, in addition to providing better intubating conditions and reducing the dose of other anesthetic drugs. Most of the current literature states a loading dose of 1 μg/kg dexmedetomidine to be superior to lower doses in this regard. Material and Methods: This is a comparative, prospective and observational study conducted at a tertiary care teaching hospital among 40 patients in each group. American Society of Anaesthesiologists (ASA) physical status I and II of either sex aged between 18 to 60 years, scheduled for elective surgeries were enrolled for the present study. The total 80 patients were randomly assigned to two groups of 40 patients each, according to computer generated random number table. Dexmedetomidine infusion was discontinued and residual neuromuscular blockade was antagonized by appropriate doses of neostigmine and glycopyrrolate and tracheal extubation was performed. Result: Mean HR in Group A was 82.6 ± 5.64 per min and in group B it was 81.74 ± 5.74 per min at baseline level, which was comparable (p>0.05). At 5 minutes and 10 minutes of drug infusion, both Group A and Group B had fall in mean HR, but Group B had statistically significant fall in HR as compared to Group A (p<0.05). Baseline SBP between two groups was comparable and found insignificant (p>0.05). There was fall in SBP from baseline value in group A while drug infusion was going on, while Group B showed transient rise from baseline value in SBP at 1 minutes of drug infusion which was statistically insignificant difference. Conclusion: Dexmedetomidine at 0.5 μg/kg loading dose provides significantly better attenuation of haemodynamic responses of endotracheal intubation unaccompanied by transient hypertension and bradycardia, which is observed at 1 μg/kg loading dose.
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Copyright (c) 2021 Mohd Imranullah Khan, Sri Vani Sailaja Ganti, Ghazia Hina, Shaikh Fahd
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