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ORIGINAL ARTICLE
Year : 2015  |  Volume : 4  |  Issue : 2  |  Page : 86-90

Comparison of intravenous lignocaine and intravenous dexmedetomidine for attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation


Department of Anaesthesiology and Critical Care, Kurnool Medical College and Government General Hospital, Kurnool, Andhra Pradesh, India

Correspondence Address:
Dr. Saya Raghavendra Prasad
Department of Anaesthesiology and Critical Care, Kurnool Medical College and Government General Hospital, Kurnool - 518 002, Andhra Pradesh
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/2277-8632.158579

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Context: Direct laryngoscopy and endotracheal intubation following induction of anesthesia is almost always associated with hemodynamic stress response due to reflex sympathoadrenal discharge. Aim: Aim of our study was to compare the efficacy of lignocaine and dexmedetomidine in attenuating the hemodynamic response to laryngoscopy and intubation. Settings and Design: The present prospective randomized study was carried out in a tertiary care teaching hospital. A total of 100 American Society of Anesthesiologist physical status I and II patients posted for elective surgery under general anesthesia were enrolled in the study. Patients were randomly divided into two groups, group L (lignocaine group) and group D (dexmedetomidine group) with 50 patients in each group. Materials and Methods: Group L received 1.5 mg/kg of lignocaine intravenous (IV) and group D received 1 mcg/kg of dexmedetomidine as IV infusion. Thiopentone was given until eyelash reflex disappeared, and intubation was facilitated with succinylcholine. Anesthesia was maintained with 33:66 oxygen: Nitrous oxide, isoflurane, and vecuronium. Hemodynamic parameters were recorded during the basal period, preinduction, after induction, during intubation, 1 min, 3 min, 5 min, and 10 min after intubation. Statistical Analysis Used: Data were analyzed using Graphpad Prism Software version 6.03 (Graphpad Software Inc., USA). P < 0.05 was considered as statistically significant. Results: Maximum increase in heart rate was around 38% in group L and 10% in group D (P = 0.000). Maximum increase in mean arterial pressure was 22% in group L and 6% in group D (P = 0.000). Thiopentone dose requirement was 19% less in group D compared to group L (P < 0.001). Conclusion: Dexmedetomidine attenuates the hemodynamic stress response to laryngoscopy and intubation more effectively compared with lignocaine without any deleterious effects. Furthermore, dexmedetomidine decreases dose of thiopentone for induction of anesthesia.


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