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Attenuation of Stress Response during Intubation for Laparoscopic Procedures: A Comparative Study between Intravenous Dexmedetomidine and Lidocaine

Deepa Gautham, Senior Resident, Karpaga Vinayaga Institute of Medical Sciences & Research Centre, Chinnakolambakkam, Madhurantagam, Kanchipuram District, Tamil Nadu 603308, India. , Mu. Raajaram1 , Deepa Gautham2

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Indian Journal of Anesthesia and Analgesia 5(9):p 1461-1468, September 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5918.6

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Abstract

Introduction: During laryngoscopy and endotracheal intubation, one of the most dreaded complications is hemodynamic instability which is a well-archived certainty and this response in most susceptible patients induces myocardial ischemia or infarction, left ventricular failure and cerebral hemorrhage due to the strong sympathetic response during the procedure.

The aim of the study: This study was aimed to compare the effect of dexmedetomidine and lidocaine on hemodynamic response to laryngoscopy and endotracheal intubation in patients undergoing elective laparoscopic procedures under general anaesthesia.

Materials and Methods: A total of sixty patients were selected and randomized into two groups of thirty patients each: dexmedetomidine-intervention group and lidocaine-control group. Inj. Dexmedetomidine by means of infusion pump was given prior to anesthetic induction, at a rate of 1g/kg IV over a period of 10 min, to all intervention group patients. Three minutes after the completion of infusion, patients were induced with general anaesthesia. As a standard procedure, plain preservative-free 2% lidocaine was given at a rate of 1.5 mg/kg IV bolus to all patients in the control group 1.5 minutes prior to laryngoscopy. Baseline parameters such as heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP), were recorded before administration of the drugs under study, at intubation, and at 1 min & 3 min after intubation.

Results: The changes in mean heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure values were significantly lower in Dexmedetomidine group when compared to the lidocaine group.

Conclusions: Dexmedetomidine when used as a pre-anesthetic medication significantly suppresses the sympathoadrenal response to laryngoscopy and endotracheal intubation without influencing intraoperative cardiovascular stability.

 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5918.6

Keywords

Dexmedetomidine; Endotracheal Intubation; Hemodynamic Response; Laryngoscopy.

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