Intravenous use of Dexmedetomidine for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation in Contrast to Intravenous Lignocaine

Background: In the very recent studies it has been reflected that direct laryngoscopic endotracheal tube intubation following induction of anaesthesia is invariably associated reflex sympathoadrenal discharge with changes in hemodynamic stress response. Objective: The main objective of this Randomized Controlled Clinical Trial (RCT) is to compare the efficacy of intravenous use of dexmedetomidine in relation to dexmedetomidine in attenuating the hemodynamic response to laryngoscopy and intubation. Study design: This study was conducted as a Randomized Controlled Clinical Trial (RCT) in Sir Salimullah Medical College, Mitford Hospital, Dhaka, Bangladesh with a total of 150 patients of elective surgery under general anaesthesia. Patients were divided into two groups on the basis of systemic random sampling, group D (dexmedetomidine group) and group L (lignocaine group) with 75 and 75 patients in respective groups. Results: Mean ± SD of age were 42.4 ± 5.459 and 40.8 ± 9.975 years respectively in group D & L. And Majority (54.7%) patients in group D were male, whereas in group L, it was 46.7%. Relatively smooth and more stable changes were observed in systolic, diastolic and Mean Arterial Pressure (MAP) following intravenous infusion of dexmedetomidine in contrast intravenous infusion of lignocaine in response to laryngoscopy and endotracheal intubation. The incidence of hypertension was 2.0% (03) and 6.7% (05) in cases of Group D and Group L respectively. Tachycardia was found in 6.7% (05) and 12.0% (05) in respective group. The incidence of hypotension, bradycardia and arrhythmia was nil in this study. 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 anaesthesia.