ATTENUATION OF HEMODYNAMIC RESPONSE TO TRACHEAL INTUBATION WITH INTRAVENOUS DEXMEDETOMIDINE IN PATIENTS UNDERGOING LAPROSCOPIC CHOLECYSTECTOMY-A COMPARISON BETWEEN TWO DOSES

Dr. Shabnam Ara; Dr. Arfath Ahmed

Volume : VIII, Issue : I, January - 2019

ATTENUATION OF HEMODYNAMIC RESPONSE TO TRACHEAL INTUBATION WITH INTRAVENOUS DEXMEDETOMIDINE IN PATIENTS UNDERGOING LAPROSCOPIC CHOLECYSTECTOMY-A COMPARISON BETWEEN TWO DOSES

Dr. Shabnam Ara, Dr. Arfath Ahmed

Abstract :

Introduction: Laryngoscopy and intubation are noxious stimuli associated with responses of laryngosympathetic stimulation like hypertension, tachycardia and arrhythmias. Drug like dexmedetomidine have the potential to blunt the hemodynamic responses to laryngoscopy and intubation. Dexmedetomidine is a highly selective short acting alpha –2 adrenoreceptor agonist. It decreases the hemodynamic response to laryngoscopy and intubation. It provides sedation, analgesia and anxiolysis with minimal respiratory depression. Aim: In this study we compared two IV doses of dexmedetomidine 0.5ug/kg and 0.75 ug/kg in attenuating stress response during laryngoscopy and intubation in patients undergoing laproscopic cholecystectomy. The study also compared the sedation score with two different IV doses of dexmedetomidine. Material and Method.: 45 ASA I –II patients in the age range of 18–50 years of either sex scheduled for laproscopic cholecystectomy were randomly allocated into 3 groups of 15 patients each. Group 1 received 20 ml of Normal Saline slowly over 10 min prior to induction of anesthesia. Group 2 received IV dexmedetomidine 0.5ug/kg in 20ml of Normal Saline slowly over 10 min prior to induction of anesthesia. Group 3 received IV dexmedetomidine 0.75ug/kg in 20ml of Normal Saline slowly over 10 min prior to induction of anesthesia. Results: There was a statistically significant difference between dexmedetomidine and normal saline group in heart rate, systolic BP and diastolic BP after laryngoscopy and intubation with dexmedetomidine 0.75ug/kg being most effective. Sedation scores were more in dexmedetomidine groups. None of the patients had any adverse effects like adycardia, hypotension and respiratory depression or desaturation. Conclusion: We concluded that IV dexmedetomidine 0.75ug/kg is the optimal dose and significantly superior to IV dexmedetomidine 0.5ug/kg in attenuating the hemodynamic response to laryngoscopy and intubation