Background and Aims: Effective use of sedative-hypnotic and analgesic agents is an integral part of providing patient comfort and safety for patients during general anaesthesia. The present study was carried out to evaluate the effects of premedication with dexmedetomidine on perioperative haemodynamic and dose requirement of propofol and fentanyl during laryngoscopy and tracheal intubation.

Methods: 100 patients belonging to ASA class I and ASA class II of either sex, in the age group of 20-55years were divided into two groups, Group 1 and Group 2 with 50 patients in each group. Group 1 received 100ml of Normal saline over a period of 10 minutes and 1µg/kg of fentanyl 3 minutes before induction of general anaesthesia. Group 2 received 1µg/kg of dexmedetomidine in 100 ml of normal saline over a period of 10 minutes and 1µg/kg of fentanyl 3 minutes before induction of general anaesthesia.

Results: The demographic profile was comparable. The pressor response to laryngoscopy, intubation, surgery and extubation were effectively decreased by dexmedetomidine, and were highly significant on comparison (P<0.001). The mean dose of fentanyl and propofol were also decreased significantly by the administration of dexmedetomidine. The total dose requirement of fentanyl and propofol was decreased by 33.58% and 43.01%  in Group 2 as compared to Group 1 and the difference was statistically significant.

Conclusions: Dexmedetomidine is an effective drug when used as an adjunct to general anaesthesia for attenuation of pressor response. It not only decreased the magnitude of stress response to intubation, surgery and extubation but also decreased the dose of propofol and opioids in achieving adequate anaesthesia and analgesia respectively.

Keywords: Dexmedetomidine, fentanyl, heart rate, propofol, mean arterial pressure, entropy, pressor response.

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Dr Nuzhat Ul Islam

Resident, Department of Anesthesiology & Critical Care,

Govt. Medical College, Srinagar, India

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