Comparison of intravenous lignocaine and intravenous dexmedetomidine in attenuating pressor response to laryngoscopy and endotracheal intubation in controlled hypertensive patients

Abstract

Background: Laryngoscopy and endotracheal intubation form the basis of controlling the patient’s airway during general anaesthesia or artificial ventilation which may have deleterious respiratory, neurological, cardiovascular effects associated with hemodynamic changes. These transient cardiovascular responses are usually well tolerated by normotensive patients and may cause no deleterious consequences in them. Patients with hypertension are known to exhibit exaggerated pressor response and complications like cardiac failure, myocardial infarction and cerebral haemorrhage. So, our aim was to evaluate the effect of intravenous preservative free 2 % Lignocaine (1.5 mg/kg) in attenuating the pressor response to laryngoscopy and tracheal intubation compared to intravenous Dexmedetomidine (1 mcg/kg).Methodology: In this study, 60 patients, aged between 40-60 years of either sex k/c/o Hypertension taking some antihypertensive medications belonging to ASA class II included and randomly allocated in 2 groups each of 30. In Group L, patients had received preservative free 2 % Lignocaine 1.5 mg/kg IV 3 minutes before intubation. In Group D, patients had received Dexmedetomidine 1mcg/kg IV diluted to 50 ml NS as an infusion over 10 minutes before induction. Result: The study revealed that there is significant difference between (p value < 0.05) the two groups during laryngoscopy and endotracheal intubation with respect to heart rate, systolic, diastolic and mean arterial BP. Conclusion: IV Dexmedetomidine significantly attenuates intubation response to laryngoscopy and endotracheal intubation with haemodynamic stability as compared with IV Lignocaine in controlled hypertensive patients.