Comparative Evaluation of Bolus Administration of Dexmedetomidine and Fentanyl for Stress Attenuation During Laryngoscopy and Endotracheal Intubation

• Main Authors: Sellamuthu Gunalan, Rajagopalan Venkatraman, Govindarajan Sivarajan, Paneerselvam Sunder
• Format: Article
• Language: English
• Published: JCDR Research and Publications Private Limited 2015-09-01
• Series: Journal of Clinical and Diagnostic Research
• Subjects: dexmedetomidine; intubation reflexes; opioids; stress response
• Online Access: https://jcdr.net/articles/PDF/6431/13827_CE[Ra1]_F(AK)_PF1(PAK)_PFA(AK)_PF2(PAG).pdf

Background: Laryngoscopy and endotracheal intubation can cause hypertension and tachycardia which can result in myocardial ischemia or stroke in vulnerable people. The objective of our study was to compare the efficacy of bolus dose of dexmedetomidine and fentanyl in attenuating haemodynamic stress responses following laryngoscopy and intubation. Materials and Methods: Sixty patients who were fixed to undergo elective surgeries under general anaesthesia were randomly divided into 2 groups. Group 1 received 1 mcg/kg of dexmedetomidine over 10 minutes and group 2 received fentanyl 2mcg/kg before induction. Anaesthesia was standardized in both the groups and vital parameters were recorded for up to 10 minutes after intubation. Results: Dexmedetomidine in a dose of 1mcg/kg prevented an increase in heart rate following laryngoscopy when compared to fentanyl group. This effect lasted for 10 minutes after intubation is performed. Though dexmedetomidine prevented an increase in blood pressure, this effect was statistically significant only for 2 minutes after intubation when compared to fentanyl group. Conclusion: Attenuation of rise in heart rate and blood pressure following laryngoscopy and endotracheal intubation was better with 1mcg/kg of dexmedetomidine when compared to fentanyl.