Abstract

EFFECT OF DEXMEDETOMIDINE ON HEMODYNAMIC RESPONSE DURING LARYNGOSCOPY AND TRACHEAL INTUBATION IN HYPERTENSIVE PATIENTS

Dr. Sristi Meghare*, Dr. Kinna Shah and Dr. Jayshree Thakkar

ABSTRACT

Introduction: Dexmedetomidine is a selective α2 adrenergic agonist. Due to prominent CVS effects, effectively prevents the hemodynamic stress response to laryngoscopy and intubation. Our aim was to compare the effects of intravenous Dexmedetomidine HCl 0.5μg/kg, 1μg/kg and 0.9% normal saline on attenuation of hemodynamic response during laryngoscopy for oral endotracheal intubation in hypertensive patients. Method: With 30 patients in each group using sealed envelope method. Hypertensive patients taking regular antihypertensive medication (Ca channel blockers and B blockers) for at least 7 days were included. Patients taking ACE inhibitors, H/o heart failure, MI were excluded. They all continued their medication in preoperative period. All study drugs were given 10 minutes of induction. Group A: Inj. Dexmedetomidine 0.5μg/kg intravenously in 100 ml normal saline, Group B: Inj. Dexmedetomidine 1 μg/kg in 100 ml normal saline infusion, Group C: 100 ml 0.9% normal saline. Results: The maximum increase in HR was 43% in group C, 4% in Group A and 2% in Group B. The mean HR returned to near baseline values at 4 mines and 2 mines after intubation in Group A and B respectively, whereas in group C, baseline values were not achieved till 8 mines after intubation. When compared to group A, Group B showed a significantly lesser increase in SBP in response to laryngoscopy and intubation till 8mins after intubation. (p<0.05). Conclusion: 1μg/kg dose was more effective in haemodynamic control in hypertensive patients in response to laryngoscopy and intubation. The incidence of sedation and side effects like hypotension and bradycardia is more with 1μg/kg of Dexmedetomidine than 0.5μg/kg.

Keywords: Hypertension, Intubation, Stress response, Dexmedetomidine, Induction Anesthesia.