Comparison of intravenous lignocaine and intravenous dexmedetomidine for attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation

Context: Direct laryngoscopy and endotracheal intubation following induction of anesthesia is almost always associated with hemodynamic stress response due to reflex sympathoadrenal discharge. Aim: Aim of our study was to compare the efficacy of lignocaine and dexmedetomidine in attenuating the hemodynamic response to laryngoscopy and intubation. Settings and Design: The present prospective randomized study was carried out in a tertiary care teaching hospital. A total of 100 American Society of Anesthesiologist physical status I and II patients posted for elective surgery under general anesthesia were enrolled in the study. Patients were randomly divided into two groups, group L (lignocaine group) and group D (dexmedetomidine group) with 50 patients in each group. Materials and Methods: Group L received 1.5 mg/kg of lignocaine intravenous (IV) and group D received 1 mcg/kg of dexmedetomidine as IV infusion. Thiopentone was given until eyelash reflex disappeared, and intubation was facilitated with succinylcholine. Anesthesia was maintained with 33:66 oxygen: Nitrous oxide, isoflurane, and vecuronium. Hemodynamic parameters were recorded during the basal period, preinduction, after induction, during intubation, 1 min, 3 min, 5 min, and 10 min after intubation. Statistical Analysis Used: Data were analyzed using Graphpad Prism Software version 6.03 (Graphpad Software Inc., USA). P < 0.05 was considered as statistically significant. Results: Maximum increase in heart rate was around 38% in group L and 10% in group D (P = 0.000). Maximum increase in mean arterial pressure was 22% in group L and 6% in group D (P = 0.000). Thiopentone dose requirement was 19% less in group D compared to group L (P < 0.001). Conclusion: Dexmedetomidine attenuates the hemodynamic stress response to laryngoscopy and intubation more effectively compared with lignocaine without any deleterious effects. Furthermore, dexmedetomidine decreases dose of thiopentone for induction of anesthesia