Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled Study
Introduction: Over the last decade, the use of dexmedetomidine has found favour in obtunding the haemodynamic response during laryngoscopy and tracheal intubation but the use of higher doses has lead to a number of adverse effects. Aim: To compare the effect of low dose dexmedetomidine (0.5 µg/...
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| Format: | Article |
| Language: | English |
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JCDR Research and Publications Private Limited
2022-02-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/15956/51731_CE(Ra1)_F(SS)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
| _version_ | 1818264692601126912 |
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| author | Maninder Kaur Sargam Goel |
| author_facet | Maninder Kaur Sargam Goel |
| author_sort | Maninder Kaur |
| collection | DOAJ |
| description | Introduction: Over the last decade, the use of dexmedetomidine
has found favour in obtunding the haemodynamic response
during laryngoscopy and tracheal intubation but the use of
higher doses has lead to a number of adverse effects.
Aim: To compare the effect of low dose dexmedetomidine (0.5 µg/
kg) and 4% sevoflurane (dial setting) with, Normal Saline (NS)
and 4% sevoflurane (dial setting) on haemodynamic response to
laryngoscopy and intubation.
Materials and Methods: This randomised double blind controlled
study was carried out in 60 patients of American Society of
Anaesthesiologists (ASA) class I, undergoing elective surgery
under general anaesthesia. The patients were allocated to group
DX (n=30) and group NS (n=30), who received dexmedetomidine
0.5 µg/kg infusion and NS infusion intravenous (i.v.) respectively,
in equal volume over 10 minutes before anaesthesia induction.
They were evaluated for the requirement of thiopentone sodium,
vecuronium bromide and sevoflurane, total i.v. fluids transfused
haemodynamic parameters intraoperatively (pre and post induction)
and postoperatively at regular intervals, and side effects.
Results: On statistical comparison, Heart Rate (HR), Systolic
Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and
Mean Arterial Pressure (MAP) were found to be significantly
less in group DX than in group NS with a p-value of <0.05.
The total i.v. fluids infused in group NS and DX expressed as
mean±Standard Deviation (SD) were 1145.00±228.21 and
1325.00±359.64, respectively. This was statistically significant.
Thiopentone requirement was statistically more in group NS
with a mean±standard deviation of 249.17±37.99 than in group
DX (225.00±38.84). Similarly, sevoflurane requirement was
statistically less in the DX group at various time intervals. Ten
patients (33%) in group DX required antiemesis, compared to
13 patients (43%) in group NS. Two patients in group NS and
three patients in group DX required injection (inj.) atropine to
treat bradycardia.
Conclusion: On comparison, a combination of 4% sevoflurane
with 0.5 µg/kg dexmedetomidine was more effective in attenuating
pressor response than 4% sevoflurane (dial setting) alone, but is
associated with minor and manageable risk of bradycardia and
hypotension. |
| first_indexed | 2024-12-12T19:38:57Z |
| format | Article |
| id | doaj.art-7d0e28676999491e90c8dae4e650683a |
| institution | Directory Open Access Journal |
| issn | 2249-782X 0973-709X |
| language | English |
| last_indexed | 2024-12-12T19:38:57Z |
| publishDate | 2022-02-01 |
| publisher | JCDR Research and Publications Private Limited |
| record_format | Article |
| series | Journal of Clinical and Diagnostic Research |
| spelling | doaj.art-7d0e28676999491e90c8dae4e650683a2022-12-22T00:14:14ZengJCDR Research and Publications Private LimitedJournal of Clinical and Diagnostic Research2249-782X0973-709X2022-02-01162UC05UC0910.7860/JCDR/2022/51731.15956Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled StudyManinder Kaur0Sargam Goel1Ex-Senior Resident, Department of Anaesthesia, University College of Medical Sciences, University of Delhi and Guru Teg Bahadur Hospital, Delhi, India.Ex-Senior Resident, Department of Anaesthesia, University College of Medical Sciences, University of Delhi and Guru Teg Bahadur Hospital, Delhi, India.Introduction: Over the last decade, the use of dexmedetomidine has found favour in obtunding the haemodynamic response during laryngoscopy and tracheal intubation but the use of higher doses has lead to a number of adverse effects. Aim: To compare the effect of low dose dexmedetomidine (0.5 µg/ kg) and 4% sevoflurane (dial setting) with, Normal Saline (NS) and 4% sevoflurane (dial setting) on haemodynamic response to laryngoscopy and intubation. Materials and Methods: This randomised double blind controlled study was carried out in 60 patients of American Society of Anaesthesiologists (ASA) class I, undergoing elective surgery under general anaesthesia. The patients were allocated to group DX (n=30) and group NS (n=30), who received dexmedetomidine 0.5 µg/kg infusion and NS infusion intravenous (i.v.) respectively, in equal volume over 10 minutes before anaesthesia induction. They were evaluated for the requirement of thiopentone sodium, vecuronium bromide and sevoflurane, total i.v. fluids transfused haemodynamic parameters intraoperatively (pre and post induction) and postoperatively at regular intervals, and side effects. Results: On statistical comparison, Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP) and Mean Arterial Pressure (MAP) were found to be significantly less in group DX than in group NS with a p-value of <0.05. The total i.v. fluids infused in group NS and DX expressed as mean±Standard Deviation (SD) were 1145.00±228.21 and 1325.00±359.64, respectively. This was statistically significant. Thiopentone requirement was statistically more in group NS with a mean±standard deviation of 249.17±37.99 than in group DX (225.00±38.84). Similarly, sevoflurane requirement was statistically less in the DX group at various time intervals. Ten patients (33%) in group DX required antiemesis, compared to 13 patients (43%) in group NS. Two patients in group NS and three patients in group DX required injection (inj.) atropine to treat bradycardia. Conclusion: On comparison, a combination of 4% sevoflurane with 0.5 µg/kg dexmedetomidine was more effective in attenuating pressor response than 4% sevoflurane (dial setting) alone, but is associated with minor and manageable risk of bradycardia and hypotension.https://jcdr.net/articles/PDF/15956/51731_CE(Ra1)_F(SS)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdfblood pressureendotracheal intubationgeneral anaesthesiaheart rate |
| spellingShingle | Maninder Kaur Sargam Goel Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled Study Journal of Clinical and Diagnostic Research blood pressure endotracheal intubation general anaesthesia heart rate |
| title | Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled Study |
| title_full | Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled Study |
| title_fullStr | Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled Study |
| title_full_unstemmed | Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled Study |
| title_short | Effect of Low Dose Intravenous Dexmedetomidine with 4% Sevoflurane on Haemodynamic Response during Laryngoscopy and Tracheal Intubation: A Randomised Controlled Study |
| title_sort | effect of low dose intravenous dexmedetomidine with 4 sevoflurane on haemodynamic response during laryngoscopy and tracheal intubation a randomised controlled study |
| topic | blood pressure endotracheal intubation general anaesthesia heart rate |
| url | https://jcdr.net/articles/PDF/15956/51731_CE(Ra1)_F(SS)_PF1(AG_SS)_PFA(AG_KM)_PN(KM).pdf |
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