A prospective randomized controlled trial comparing the effects of dexmedetomidine and fentanyl on attenuation of pressor response during laryngoscopy and intubation in neurosurgical patients

Authors

  • Shazia Anjum Department of Anaesthesiology and critical care Sheri Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India
  • Sarbjit Singh Chhiber Department of Anaesthesiology and critical care Sheri Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India
  • Majid Khan Department of Anaesthesiology and critical care Sheri Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India
  • Zulfiqar Ali Department of Anaesthesiology and critical care Sheri Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India
  • Talib Khan Department of Anaesthesiology and critical care Sheri Kashmir Institute of Medical Sciences Soura, Srinagar, Jammu and Kashmir, India

DOI:

https://doi.org/10.18203/2320-6012.ijrms20193615

Keywords:

Dexmedetomidine, Fentanyl, Intubation, Laryngoscopy, Sympathetic response

Abstract

Background: Laryngoscopy is associated with a sympathetic response that results in a rapid increase in blood pressure and heart rate in these patients. The mechanisms underlying these hemodynamic changes are incompletely understood. They may be caused by a reflex sympathetic discharge due to stimulation of the upper respiratory tract. It has been observed that hemodynamic responses to tracheal intubation are associated with an increase in plasma catecholamine concentrations and are attenuated by β-adrenergic blockade. These hemodynamic changes may be undesirable particularly in neurosurgical patients. Aim of the study is the present study was prospective, randomized, double-blind conducted to evaluate the efficacy of dexmdetomidine and fentanyl in attenuation of pressor responses to laryngoscopy and intubation in neurosurgical patients undergoing lumbar spine surgeries.

Methods: A total of 60 patients of 18–65 years, American Society of Anaesthesiologists Class I/II of undergoing elective neurosurgical procedures were included in the study. The patients were divided into two groups of 30 patients each. Group D received dexmedetomidine and Group F received Fentanyl. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial blood pressure (MAP) were recorded preoperatively (baseline), at 5 and 8 minutes after infusion of study drug, before induction, 1 minute after induction, 2 minute after intubation, 5 minute after intubation, 10 minute after intubation  and 15 minute after intubation.

Results: There was a better control of Heart rate, systolic blood pressure, diastolic blood pressure   and mean arterial pressure in Group D when compared to Group F during laryngoscopy and after intubation.

Conclusions: The present study shows that dexmedetomidine suppresses hemodynamic responses effectively than fentanyl.

References

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Published

2019-08-27

How to Cite

Anjum, S., Chhiber, S. S., Khan, M., Ali, Z., & Khan, T. (2019). A prospective randomized controlled trial comparing the effects of dexmedetomidine and fentanyl on attenuation of pressor response during laryngoscopy and intubation in neurosurgical patients. International Journal of Research in Medical Sciences, 7(9), 3246–3250. https://doi.org/10.18203/2320-6012.ijrms20193615

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Original Research Articles