A randomized double blind study to evaluate the effect of nebulized dexmedetomidine on the haemodynamic response to laryngoscopy – Intubation and intubation conditions

Abstract

: A cardiovascular stress response is frequently brought on by direct laryngoscopy and intubation. It is widely known that the sympathetic adrenal stimulation elicited by mechanical stimulation to the upper respiratory tract is what causes the haemodynamic response during laryngoscopy and intubation. The study's goal was to assess the impact of preoperative dexmedetomidine nebulization on the patient's hemodynamic response to laryngoscopy- intubation and the intubation conditions.: The American Society of Anaesthesiologists (ASA) I & II adult patients, of either gender, undergoing elective surgeries requiring tracheal intubation were randomized to receive nebulized dexmedetomidine (Group D) or 0.9% saline (Group P), 30 minutes prior to the induction of anesthesia. This study was conducted in the department of anesthesia and critical care at the Christian Medical College in Ludhiana. Following laryngoscopy, the patient's heart rate and non-invasive systolic and diastolic blood pressure will be monitored for 10 minutes. The intubation conditions were noted during laryngoscopy.Total 100 patients with 50 in each group were included. At the time of laryngoscopy and after the intubation 1 min, 3 min,5 min, 7min and 10 min there were significantly lower trend in increasing HR, SBP, DBP and RPP in dexmedetomidine group versus saline. The intubation score representing conditions for intubation was significantly better in the dexmedetomidine group (P=0.013) than the saline group. There was no significant side effect noted (p=1.000). There was significant reduction in intraoperative analgesic and sedative requirement observed in dexmedetomidine groupOur study concluded that the nebulized dexmedetomidine attenuated haemodynamic response to laryngoscopy- intubation and provided better intubation conditions without significant side effects. We advise using nebulized dexmedetomidine pre-operatively for a surgical procedure requiring general anesthesia in order to reduce the haemodynamic response to intubation and to facilitate intubation conditions without experiencing any severe adverse effects.