Dexmedetomidine premedication: Effect on pressor response to laryngoscopy and intubation

OBJECTIVE: Dexmedetomidine and Fentanyl are used to attenuate the sympathetic response to laryngoscopy and intubation. Aim is to study and compare the attenuation of haemodynamic response during laryngoscopy and intubation. METHODS: 60 ASA Class 1 & 2 patients aged between 18-80 years, posted for elective surgeries were randomized into two groups. GROUP C-Premedication with 2 mcg/kg Fentanyl and GROUP D-premedication with 1 mcg/kg Dexmedetomidine + 2mcg/kg Fentanyl. Both groups were preloaded with 10ml/kg crystalloid solution. The parameters measured were propofol dose requirement for induction, heart rate(HR), SBP,DBP and MAP(mean arterial pressure). RESULTS: Propofol requirements were 26.6% lesser in Group D (P<0.000 HS). There was a initial rise of HR during intubation in both the groups. Heart rate was significantly low at baseline(P;0.008), induction (P;0.006) and at intubation(P;0.001) in Group D. Cardiovascular parameters like MAP (P;0.007) SBP(P;0.005) and DBP(P;0.007) were significantly lower in Group D compared to Group C only at baseline. There were no differences at any other point during the study. CONCLUSION: Dexmedetomidine decreases the requirements of propofol for induction and also attenuates the haemodynamic response to intubation.