EFFECT OF NEBULISED DEXMEDETOMIDINE ON HEMODYNAMIC RESPONSE TO INTUBATION

Authors

  • NEEMA ANN SABU Department of Anaesthesiology, Government Medical College, Kottayam, Kerala, India
  • REGIMOL V VARGHESE Department of Anaesthesiology, Government Medical College, Kottayam, Kerala, India
  • SUSAN T CHEERAN Department of Anaesthesiology, Government Medical College, Kottayam, Kerala, India

DOI:

https://doi.org/10.22159/ajpcr.2023.v16i3.47739

Keywords:

Stress response , Nebulized dexmedetomidine, Laryngoscopy, Intubation

Abstract

Objective: The aim of the study was to determine the role of nebulized dexmedetomidine in attenuating the stress response to laryngoscopy and intubation and to observe any adverse effects of the drug such as cough, bradycardia, hypotension, and dose-sparing result of propofol.

Methods: A prospective and observational study was conducted in a tertiary care teaching hospital for 12 months. A total of 62 patients (ASA 1 and 2) in the age group of 18–65 years scheduled for elective surgery under general anesthesia received either nebulized dexmedetomidine 10 min before intubation (Group A) or Inj. Lignocaine 90 s before intubation (Group B). Post-intubation hemodynamic parameters were compared in both groups. Data collected remained analyzed using SPSS version 16.

Results: Both groups were comparable with respect to demographic variables. Nebulization with Inj. Dexmedetomidine showed statistically significant blunting of hemodynamic response in the 1st min following intubation, in Group A. This was seen in the variables such as heart rate, diastolic blood pressure, and mean arterial blood pressure. There was no significant difference in the systolic blood pressure at all points of time. Furthermore, there was no significant change in the variables at 5 and 10 min following intubation. There was a significant decrease in the dose of propofol required for induction in Group A compared to Group B.

Conclusion: Nebulization with dexmedetomidine before laryngoscopy and intubation significantly reduced the hemodynamic response to intubation, immediately after intubation.

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References

Kaur M, Singh PM. Current role of dexmedetomidine in clinical anesthesia and intensive care. Anesth Essays Res 2011;5:128-33.

Afshani N. Clinical application of dexmedetomidine. S Afr J Anaesth Analg 2010;16:50-6.

Yazbek-Karam VG, Aouad MM. Perioperative uses of dexmedetomidine. Middle East J Anesthesiol 2006;18:1043-58.

Mason KP, Lerman J. Review article: Dexmedetomidine in children: Current knowledge and future applications. Anesth Analg 2011;113:1129-42.

Zanaty OM, El Metainy SA. A comparative evaluation of nebulized dexmedetomidine, nebulized ketamine, and their combination as premedication for outpatient pediatric dental surgery. Anesth Analg 2015;121:167-71.

Surendar MN, Pandey RK, Saksena AK, Kumar R, Chandra G. A comparative evaluation of intranasal dexmedetomidine, midazolam and ketamine for their sedative and analgesic properties: A triple blind randomized study. J Clin Pediatr Dent 2014;38:255-61.

Anupriya J, Kurhekar P. Randomised comparison between the efficacy of two doses of nebulised dexmedetomidine for premedication in paediatric patients. Turk J Anaesthesiol Reanim 2020;48:314-20.

Kumar NR, Jonnavithula N, Padhy S, Sanapala V, Naik VV. Evaluation of nebulised dexmedetomidine in blunting haemodynamic response to intubation: A prospective randomised study. Indian J Anaesth 2020;64:874-9.

Sale HK, Shendage VJ. Lignocaine and dexmedetomidine in attenuation of pressor response to laryngoscopy and intubation: A prospective study. Int J Sci Study 2015;3:155-60.

Misra S, Behera BK, Mitra JK, Sahoo AK, Jena SS, Srinivasan A. Effect of preoperative dexmedetomidine nebulization on the hemodynamic response to laryngoscopy and intubation: A randomized control trial. Korean J Anesthesiol 2020;74:150-7.

Walia C, Gupta R, Kaur M, Mahajan L, Kaur G, Kaur B. Propofol sparing effect of dexmedetomidine and magnesium sulfate during BIS targeted anesthesia: A prospective, randomized, placebo controlled trial. J Anaesthesiol Clin Pharmacol 2018;34:335-40.

Senapati LK, Samanta P. Effect of dexmedetomidine on dose requirement of propofol and thiopentone induction in patients under general endotracheal anesthesia. Asian J Pharm Clin Res 2018;11:262-5.

El-Shmaa NS, El-Baradey GF. The efficacy of labetalol vs dexmedetomidine for attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation. J Clin Anesth 2016;31:267-73.

Zanaty OM, El Metainy SA. A comparative evaluation of nebulized dexmedetomidine, nebulized ketamine, and their combination as premedication for outpatient pediatric dental surgery. Anesth Analg 2015;121:167-71.

Niyogi S, Biswas A, Chakraborty I, Chakraborty S, Acharjee A. Attenuation of haemodynamic responses to laryngoscopy and endotracheal intubation with dexmedetomidine: A comparison between intravenous and intranasal route. Indian J Anaesth 2019;63:915.

Published

07-03-2023

How to Cite

NEEMA ANN SABU, REGIMOL V VARGHESE, and SUSAN T CHEERAN. “EFFECT OF NEBULISED DEXMEDETOMIDINE ON HEMODYNAMIC RESPONSE TO INTUBATION”. Asian Journal of Pharmaceutical and Clinical Research, vol. 16, no. 3, Mar. 2023, pp. 155-8, doi:10.22159/ajpcr.2023.v16i3.47739.

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Original Article(s)