Comparative Study of Dexmedetomidine and Fentanyl to Obtund the Pressure Response to Laryngoscopy and Intubation

Airway manipulation during endotracheal intubation is associated with hemodynamic and cardiovascular responses. Different agents have been used to obtund the pressure response. Objectives: To evaluate the place of Dexmedetomidine for routine use during induction of anesthesia to blunt pressure response to laryngoscopy and intubation. Methodology: One hundred patients of ASA I and II were randomly divided into two groups. Group A received Midazolam (0.05 mg/kg) a n d Fentanyl (2 mcg/Kg) and group B received Dexmedetomidine (0.6 mcg/kg) 10 minutes before induction of anesthesia. Both groups were induced with Propofol (1.5 mg/Kg). In all patients after induction (loss of eye lashes reflex) tracheal intubation was facilitated using Rocuronium 1mg/kg. Baseline heart rate was noted and hemodynamic response to intubation was observed 3, 6 and 9 minutes after intubation. Results: In group A, time for loss of eyelashes reflex was 17.45±2.19 seconds and in group B it was 11.33±2.64 seconds. In group A, after intubation heart rate increased by 11.22±2.37, 5.71±1.68, 2.34±1.73 in3, 6 and 9 minutes respectively. In group A, after intubation MAP increased by 6.49±1.37, 3.30±1.15, and 1.24±1.50 from baseline in 3,6, and 9 minutes respectively. In group B after intubation heart rate increased by 2.49±0.89 from baseline at third minutes, however decreased by 2.85±1.58 and 4.73±1.86 at sixth and ninth minute respectively. In group B, MAP increased from baseline by 3.44±1.06 in third minute however decreased by 2.22±1.38 and 4.24±3.40 at sixth and ninth minutes respectively. Conclusion: Both the agents were observed to obtund pressure response to laryngoscopy and intubation however Dexmedetomidine proved to be better option compared to Fentanyl.