DEXMEDETOMIDINE ATTENUATES THE STRESS RESPONSE TO LARYNGOSCOPY ENDOTRACHEAL INTUBATION AND REDUCES THE DOSE OF THIOPENTONE

CORRESPONDING AUTHOR:
Mushtaq Ahmad Rather,
Senior Resident,
Department of Anesthesiology & Critical Care,
GMC, Srinagar-190006.
Email:  mushtaqahmad767@gmail.com

ABSTRACT: BACKGROUND: Dexmedetomidine, an α-2 adrenoreceptor agonist, is gaining popularity for its sympatholytic, anaesthetic sparing and haemodynamic stabilizing properties without significant respiratory depression. METHODS: We assessed the efficacy of dexmedetomidine in attenuating stress response to laryngoscopy, endotracheal intubation and analyzed reduction in the dose of thiopentone. Sixty patients scheduled for elective general abdominal surgeries were randomly selected. Control group (C) received isoflurane–opioid-saline and study group (D) received isoflurane–opioid-dexmedetomidine anaesthesia. Dexmedetomidine infusion in a dose of 1 μg/kg and Saline (at same rate-ml/hr.) was given over 10 min before the induction of anaesthesia. All patients were induced with thiopentone, fentanyl and vecuronium. Haemodynamic variables were recorded at different time intervals. RESULTS: The need for thiopentone was decreased by 22.96% in the dexmedetomidine group as compared to the control group. After laryngoscopy and endotracheal intubation, maximal average increase was 8.18% in systolic and 10.07% in diastolic blood pressure in dexmedetomidine group, as compared to 33.81% and 24.02%, respectively, in the control group. Similarly, average increase in heart rate was 7.48% and 19.28% in the dexmedetomidine and control groups, respectively. CONCLUSION: Preoperative infusion of dexmedetomidine is effective in attenuating the stress response to laryngoscopy and endotracheal intubation. It has significant anaesthetic sparing effect.

KEYWORDS: α-2 adrenoreceptor, dexmedetomidine, stress response, laryngoscopy, endotracheal intubation