Abstract
Background: Laryngoscopy and endotracheal intubation violate the patient’s protective airway reflexes and invariably cause hemodynamic changes associated with increased heart rate, increased blood pressure and occasional disturbance in cardiac rhythm.
Aim: The aim of the study was to find the efficacy of α2-adrenoceptors agonist in attenuating pressor response while securing airway during surgery.
Methods: Ninety patients of ASA physical status I and II, in the age group between 25and 50 years, of either sex, undergoing various elective abdominal surgeries under general anaesthesia were randomly allocated into three groups. Both clonidine and dexmedetomidine administered intravenously just before laryngoscopy and endotracheal intubation effectively attenuated the hemodynamic response by limiting the extent of rises in heart rate and blood pressure.
Result: Dexmedetomidine has been found to provide better hemodynamic stability than clonidine.
Keywords: Laryngoscopy, .Dexmedetomidine, clonidine.
References
- King BD, Hartris LC, Greifenstein FE, Elder JD, Dripps RD. Reflex circulatory responses to direct laryngoscopy and tracheal intubation performed during general anaesthesia. Anesthesiology 1951; 12: 556-66.
- Boralessa H, Senior DF, Whitman JC. Cardiovascular response to intubation. Anaesthesia1983; 38: 623-7.
- Forbes AM, Dally FG. Acute hypertension during induction of anaesthesia and endotracheal intubation in normotensive man.Br J Anaesth 1970; 42: 618-24.
- Fox EJ, Sklar GS, Hill CH, Villanueva R, King BD. Complications related to the pressor response to endotracheal intubation Anesthesiology 1977; 47:524-5.
- Bukhar SA, Naqash I, Zargar J, et al. Pressor responses and intraocular pressure changes following insertion of laryngeal mask airway: comparison with tracheal tube
- Bhana N, Goa KL, McClean KJM. Dexmedetomidine. Drugs 2000; 59: 263insertion. Indian J Anaesth 2003; 47(6): 473-5.
- Viurtanen R, Savola JM, Sauno V, Nyman L. Characterization of selectivity, specif-icity and potency of dexmedetomidine as α2adrenoreceptor agonist. Eur. J. Pharmacol. 1988; 159: 9-14.
- Barash PG, Cullen BF, Stoelting RK, Cahalan MK, Stock MC. Clinical Anesthesia, 6th Lippincott Williams & Wilkins 2009: 354-5.
- Stoelting RK, Hillier SC. Pharmacology and Physiology in AnestheticPractice, 4th Lippincott Williams & Wilkins 2006:340-5.
- Derbyshire DR, Chmielewski A, Fell D, et al. Plasma catecholamine responses to tracheal intubation. Br J Anaesth 1983; 55: 855-9.
- Shribman AJ, Smith G, Achola KJ. Cardiovascular and catecholamine responses to laryngoscopy with and without tracheal intubation.Br J Anaesth 1987; 59: 295-9.
- Kaya C, Kelsaka E, Sarihasan B, et al. The effects of intramuscular dexmedetomidine premedication on hemodynamics, plasma norepinephrine, cortisol and glucose concentrations. M.Ü. Tıp Dergisi 2006; 23(1): 9-16.
- Bedford RF. Circulatory responses to tracheal Problems in Anesthesia, Philadelphia, JB Lippincott 1988; 2: 203-10.
Corresponding Author
Dr Malaya Ku Patel
VIMSAR, BURLA