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International Journal of Recent Trends in Science and Technology, ISSN 2277-2812 E-ISSN: 2249-8109
Volume 11, Issue 2, June 2014 pp 187-191
Dexmedetomidine attenuates pressor response to tracheal intubation and reduces the need for propofol and perioperatrive fentanyl
Balwinderjit Singh1, Iqbal Singh2, Rajvinder Singh3
1Associate Professor, 2Professor and Head , 3Assistant Professor, Department of Anaesthesia and Intensive Care, Punjab Institute of Medical Sciences, Jalandhar- 144006, Punjab, INDIA.
Academic Editor: Dr. Aher K. R.
Background: Dexmedetomidine is a new highly selective alpha- 2 adrenoceptor agonist. It is known for its sedative, sympatholytic and cardiovascular effects. Material and methods: we assessed the safety and efficacy of dexmedetomidine as a preanaesthetic agent and in attenuating pressor response during laryngoscopy and intubation and requirement of induction agent and opioids during perioperative period. 60 Adult patients (ASA- 1) were enrolled in the study and randomized into two groups. Group – I (Dexmedetomidine group) received isoflurane - opioid – dexmedetomidine as part of balanced anaesthesia. Group - II (Saline group) received isoflurane – opioid - saline as a part of balanced anaesthesia. ECG, heart rate, blood pressure were recorded as a basal value, pre-induction, induction, 0 min after intubation, 5 min after intubation. Total required doses of propofol and opioids were recorded during perioperative period. Statistical evaluation was performed using analysis of variance (ANOVA) for repeated measurements with one between factor (drug)and one within factor (time). Data were analysed with student t test, Mann- Whitney U test. P less than 0.05 was considered statistically significant. Results: The two groups were comparable in terms of patient's characteristics (age, weight, sex, duration of surgery and type of surgery). Total propofol requirement during induction was significantly decreased in dexmedetomidine group. Isoflurane, opioids requirement during perioperative period was also significantly decreased in dexmedetomidine group. Maximum average rise in systolic, diastolic and heart rate from basal value to 0 mins after intubation is 7.6% ,10%, 15% in dexmedetomidine group and 22%, 18%, 24% in control group respectively. Conclusion: Dexmedetomidine as a preanaesthetic agent and perioperative infusion is effective in attenuating pressor response to endotracheal intubation and has significant anaesthetic and opioid sparing effect.