A STUDY ON COMPARISON OF INTRAVENOUS DEXMEDETOMIDINE WITH INTRAVENOUS FENTANYL FOR SUPPRESSION OF HEMODYNAMIC RESPONSES TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION DURING GENERAL ANAESTHESIA

Abstract

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.