Comparative Evaluation of Dexmedetomidine and Fentanyl Infusion on Haemodynamic Response in Patients Undergoing Elective Surgery Under General Anaesthesia

Abstract

Context: The procedures like laryngoscopy and intubation evoke stress response in patients undergoing elective surgeries under general anaesthesia Aims: To compare and evaluate dexmedetomidine and fentanyl on hemodynamic response like Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) in patients during intubation and extubation. Settingsand Design: Doubleblinded Randomised Control prospective Study Materials and Methods: AAfterobtainingethical clearance, 90 patients belonging to American Society of Anaesthesiologists class I/II, Scheduled for surgeries with duration of approx. 90mins were randomly divided into two groups. Group A received dexmedetomidine 1µg/ kg as loading dose over 10mns prior to induction followed by infusion at 0.5µg/kg/hr until 10mins prior to extubation. Group B received IV Fentanyl 1µg/kg as loading dose over 10mins prior to induction followed by infusion at 0.5 µg/kg/hr until 10mins prior to extubation. Exclusion criteria included cardiovascular disease, Obesity >30kg/m2, patients with anticipated difficult airway, on sedatives, hypnotics and who have allergy to the study drug. Statistical analysis used: Data analyzed- SPSS22.0 software. Test of significance: Chi-squaretest. Continuousdata: Mean standard deviation. Testof significance:Independentttest p value: <0.05- statistically significant.> Results: With respect to hemodynamic response during intubation and extubation, Group A has shown significantly lower HR, SBP, DBP and MAP in comparison to Group B. Postoperative Visual Analogue Score for first 24hrs was significantly less in Group A compared to Group B. Conclusion: Dexmedetomidine is better and safe alternative to fentanyl in attenuating hemodynamic response during both intubation and extubation.