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Materials and Methods   This clinical trial was conducted on 90 patients, aged 30–70 years, who had heart surgery. The participants were categorized into three groups. Group D received 1  µ g/kg intravenous dexmedetomidine in 10 minutes, group L received 1.5 mg/kg lidocaine (1%) 90 seconds before intubation, and group F received 2  µ g/kg fentanyl. The vital signs (HR, SBP, DBP, and MAP) were measured before intubation and 1st, 3rd, 5th, and 10th minutes after intubation. Data were analyzed with SPSS 19 software (chi-square, one-way ANOVA, or Kruskal–Wallis).Results   The age ( P =0.389) and gender distributions of patients were similar in all three groups. Dexmedetomidine significantly attenuated HR in the 3 rd  ( P =0.001), 5 th  ( P =0.001), and 10 th  ( P =0.003) minutes after intervention. It also reduced the systolic blood pressure in the 5 th  ( P =0.024) and 10 th  ( P =0.006) minutes. This reduction was significantly higher in the dexmedetomidine group than that in the two other groups. In addition, dexmedetomidine caused a greater reduction in MAP in the 1 st  ( P =0.048), 5 th  ( P =0.0001), and 10 th  ( P =0.0001) minutes.  Discussion . All three medications were effective in controlling HR; however, dexmedetomidine caused bradycardia in the 3 rd , 5 th , and 10 th  minutes. Lidocaine resulted in an increase in MAP in the 1 st  minute after intubation; whereas, dexmedetomidine reduced MAP at the 5 th  and 10 th  minutes after intubation. Changes in blood pressure and mean arterial pressure in the fentanyl group was lower than the two other groups.Conclusion   As a result, dexmedetomidine was not suitable for hemodynamic control and led to hypotension and bradycardia; on the other hand, fentanyl was more effective than two other medications in patients undergoing cardiac surgery. This trial is registered with  IRCT2017013132320N1 .

anesthesiology research and practice

Comparison of Dexmedetomidine, Lidocaine, and Fentanyl in Attenuation Hemodynamic Response of Laryngoscopy and Intubation in Patients Undergoing Cardiac Surgery