A comparison of intravenous dexmedetomidine v/s inj. fentanyl for attenuation of hemodynamic responses during laryngoscopy and intubation after propofol induction.

ABSTRACT

Background And Objective: Alpha-2 agonists are being increasingly used as adjuncts in general anaesthesia, Fentanyl an opioid analgesic, is popular as an intraoperative agent due to the cardiovascular stability provided by it, even in critically ill patients.Present study was carried out to evaluate the effect of dexmedetomidine and fentanyl for attenuation of haemodynamic responses during laryngoscopy and tracheal intubation. Methods: Sixty patients scheduled for elective general surgery under general anaesthesia were randomized into two groups A and B (n=30 in each group). Study group A patients were given inj. dexmedetomidine 1μg kg-1 diluted to 20ml normal saline infused in 10 minutes with infusion pump and group B were given inj. fentanyl 2μg kg-1 diluted to 20ml normal saline infused in 10 minutes with infusion pump, inj. Propofol (2mg/kg) i.v were used as induction agent. Anaesthesia was maintained with 4060 oxygen nitrous oxide, isoflurane (0.6%) and muscle relaxant vecuronium bromide in incremental doses throughout the surgery. Haemodynamic parameters were recorded at regular intervals during induction, intubation, surgery and extubation. Results: After induction there was significant decrease in pulse rate with dexmedetomidine and significant decrease in Mean blood pressure was seen with fentanyl group. After laryngoscopy and intubation, increase in pulse rate and mean arterial blood pressure was more in fentanyl group than in dexmedetomidine group. Interpretation and Conclusion: we conclude that dexmedetomidine 1μg/kg is more effective in attenuating hemodynamic pressure responses to laryngoscopy and intubation than 2μg/kg fentanyl when given as premedication.