Dexmedetomidine versus Fentanyl in Attenuation of Haemodynamic Response during Laryngoscopy and Intubation- A Randomised Controlled Trial

Abstract

Introduction: Endotracheal intubation is a strong adrenergic stimulus leading to unpredictable increase in heart rate, systolic and diastolic blood pressure which can be detrimental. Various drugs like dexmedetomidine and fentanyl are used for the attenuation of these responses. Aim: To compare the effects of Dexmedetomidine (1 μg/kg) and Fentanyl (2 μg/kg) on haemodynamic response to endotracheal intubation and on anaesthetic requirements. Materials and Methods: This study included 100 patients, undergoing elective surgeries under general anaesthesia. Patients were randomised into Group D (Inj. Dexmedetomidine 1 μ μg/kg iv in 100 mL normal saline) and Group F (Inj. Fentanyl 2 μ μg/kg iv in 100 mL normal saline). Vital monitoring (HR, SBP, DBP, MAP, SpO2) was done. Continuous variables were analysed with unpaired t-test and Mann Whitney U test. Categorical variables were analysed with the Chi-square test. Results: The age range of the study participants were 20-60 years. It was found that magnitude of increase in heart rate at intubation and 1 min after intubation was statistically higher in Group F as compared to Group D. SBP and DBP during intubation and at 1 min after intubation were also significantly higher in group F as compared to Group D. Conclusion: Dexmedetomidine is more effective in attenuating the sympathetic response of laryngoscopy and intubation as compared to Fentanyl.

Keywords

• endotracheal intubation
• general anaesthesia