Comparison of Intranasal Versus Intravenous Dexmedetomidine to Attenuate Haemodynamic Response of Laryngoscopy and Endotracheal Intubation in Elective Lumbar Spine Surgery: A Randomized Controlled Study

Abstract

Background: In general anaesthesia, hemodynamic alterations during endotracheal intubation are vital concerns. The efficacy of intranasal and intravenous Dexmedetomidine (DEX) in decreasing the stress response generated by laryngoscopy and endotracheal intubation was investigated in this study. Methods: Seventy adults were randomised into two groups in this prospective, randomised, double-blind study: Group DIV (n=35) and Group DIN (n=35). Dexmedetomidine (DEX) infusion (0.5 μg /kg) was administered intravenously over 40 minutes to the DIV group and intranasally (1 μg /kg) to the DIN group 40 minutes before induction. The primary outcome was to compare the mean arterial pressure (MAP) between the two groups starting 40 minutes before induction and continuing every 10 minutes until induction of anaesthesia, at the time of intubation, and then every minute afterwards until 5 minutes, 7 minutes, and 10 minutes following intubation. Comparisons of heart rate (HR), systolic (SBP) and diastolic blood pressure (DBP), sedation and any adverse effects were the secondary outcomes. Results: The two groups had no statistically significant difference in MAP, HR, SBP and DBP. The DIV group's preoperative sedation score before induction was significantly higher than the DIN group's (P = 0.014). Conclusion: This study demonstrates that dexmedetomidine administered intravenously is equally efficient as intranasal dexmedetomidine in attenuating hemodynamic response during laryngoscopy and intubation.