Published: 2017-01-03

Effect of intravenous dexmedetomidine (1µg/kg) in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% lignocaine (1.5mg/kg)

Saibaba Samala, Pradeep S. Indurkar


Background: Haemodynamic variation during layngoscopy/intubation is always a matter of concern for Anesthesiologists. A stable circulatory system is the wish of all performing general anaesthesia. Hence an acceptable and easy method needs to be established to prevent the haemodynamic variations. Our aim was to evaluate the effect of intravenous Dexmedetomidine (1µg/kg) infusion in obtunding the pressor response to laryngoscopy and tracheal intubation compared to intravenous preservative free 2% Lignocaine (1.5mg/kg).

Methods: In this study, 60 patients, aged between 18-60 years belonging to ASA I and II are included. They were randomly divided into 2 groups, each comprising of 30. In group D, patients were given Dexmedetomidine 1µg/kg IV infusion over 10min and in group L, patient were given Lignocaine 1.5mg/kg IV.

Results: In group D, the systolic, diastolic, mean arterial pressure and heart rate decreased significantly, from baseline, at first, second, third, fourth and fifth minute post intubation. In group L, the systolic, diastolic, mean arterial pressure and heart rate increased from baseline at first and second minute and then decreased at third, fourth and fifth minute post intubation.

Conclusions: When compared between the two groups all the hemodynamic parameters showed statistical significance. There are no significant side effects and severe haemodynamic variability like hypotension and bradycardia. Therefore we concluded that Dexmedetomidine is superior to lignocaine in blunting the hemodynamic response to laryngoscopy and endotracheal intubation without any significant side effects.



Intubation, Haemodynamic changes, Dexmedetomedine, Lignocaine (Preservative free)

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Gel R, Rani R, Singh OP, Malviya D, Arya SK. Attenuation of cardiovascular response to laryngoscopy and intubation by various drugs in normotensive patients, Hospital today. 2000:9.

Stoelting RK. Blood pressure and heart rate changes during short duration laryngoscopy for tracheal intubation. Influence of viscious or intravenous lidocaine. Anaesthesia analgesia. 1978;57:197-9.

Roberts P, Lt G, Meloche RM, Foex P. Studies of anaesthesia in relation to hypertension – ii. Haemodynamic consequences of induction and endotracheal intubation. British journal of anesthesia. 1971:43:541-7.

Fuji Y, Saitoh Y, Takahashi S, Toyooka H. Diltiazem – Lidocaine combination for the attenuation of cardiovascular responses to tracheal intubation in hypertensive patients. Canadian journal of anesthesia. 1998:45:935-7.

Fox EJ, Sklar GS, Hill CH, Villanueva R, King BD. Compilation related to the pressor response to endotracheal intubation, Anaesthesiology. 1977:47:524-5.

Dalton B, Guiney T. Myocardial ischemia from tachycardia and hypertension in coronary heart disease – Patients undergoing anaesthesia. Boston. Ann Mtg American Society of Anaesthesiologists. 1972: 201-2.

Donegan MF, Bedford RF. Intravenously administered lignocaine prevents intracranial hypertension during endotracheal suctioning. Anesthesiology. 1980;52(6):516-8.

Reid LC, Brace DE. Irritation of the respiratory tract and its reflex effect upon heart. Surg Gynaec & Obst; 1940; 70: 157-62.

Tam S, Chung F, Campbell M. Intravenous lignocaine. Optimal time for injection before tracheal intubation. Anaesthesia, analgesia. 1987:66:1036-8.

Menda F, Koner O, Sayin M, Ture H, Imer P, Aykac B. Dexmedetomidine as an adjunct to anaesthetic induction to attenuate hemodynamic response to endotracheal intubation in patients undergoing fast track CABG. Annals of cardiac anaesthesia. 2010;13(16):16-21.

Scheinin B, Lindgren L, Randell T, Scheinin H, Scheinin M. Dexmedetomidine attenuates sympathoadrenal responses to tracheal intubation and reduces the need for thiopentone and per operative fentanyl. British journal of anaesthesia. 1992;68(2):126-31.

Jaakola ML, Ali-Melkkila T, Kanto J, Kallio A, Scheinin H, Scheinin M. Dexmedetomidine reduces intraocular pressure, intubation responses and anaesthetic requirements in patients undergoing ophthalmic surgery. British journal of anaesthesia. 1992; 68: 570-5.

Yildiz M, Tavlan A, Tuncer S, Reisli R, Yosunkaya A, Otelcioglu S. Effect of dexmedetomidine on haemodynamic responses to laryngoscopy and intubation. Perioperative haemodynamics and anaesthetic requirements. Drugs R D. 2006:7(1)43-52.

Jain D, Khan RM, Maroof M. Effect of dexmedetomidine on stress response to extubation. The internet journal of anaesthesiology. 2009;21.

Talke P, Chen R, Thomas B, Aggarwall A, Gottlieb A, Thorborg P et al. The haemodynamic and adrenergic effects of perioperative dexmedetomidine infusion after vascular surgery. Anaesthesia and analgesia. 2000;90(4):834-9.

Malde AD, Sarode V. Attenuation of the hemodynamic response to endotracheal intubation. Fentanyl versus Lignocaine. The internet journal of anaesthesiology. 2007;12(1).

Wilson IG1, Meiklejohn BH, Smith G. Intravenous lignocaine and sympathoadrenal response to intubation. The effect of varying timing of injection. Anaesthesia. 1991;46(3):177-80.