Dexmedetomidine premedication with three different dosages to attenuate the adverse hemodynamic responses of direct laryngoscopy and intubation : a comparative evaluation

Abstract EN

Direct laryngoscopy and tracheal intubation predictably lead to transient and variable hemodynamic responses, which can be attenuated by 2-receptor agonists.

The present study aimed to evaluate comparatively the three different dosages of dexmedetomidine (0.5, 0.8, and 1 g / kg) as premedication for the attenuation of these hemodynamic responses of direct laryngoscopy and intubation.

Participants and methods Ninety adult consented patients of ASA grades I and II of either sex were randomized into three equal groups of 30 patients each in a double-blind manner.

Dexmedetomidine in dosages of 0.5 g / kg (group I), 0.8 g / kg (group II), and 1 g / kg (grou p III) was infused over 10 min as premedication before propofol induction.

The hemodynamic changes during infusion, after induction, and after laryngoscopy and intubation were recorded for statistical analysis.

Results Patients with a comparable demographic profi le showed a decrease in heart rate and blood pressure after dexmedetomidine infusion in a dose-dependent manner.

Further decrease in heart rate and blood pressure after propofol induction showed a statistically signifi cant (P < 0.05) difference among groups.

After laryngoscopy and intubation, the increase in heart rate and blood pressure was more evident in patients in whom low dosages of dexmedetomidine was infused with a statistically signifi cant (P < 0.05) difference among the groups.

Conclusion Premedication with dexmedetomidine at a dosage of 1 g / kg attenuated the adverse hemodynamic responses of laryngoscopy and intubation adequately.