Systematic Approach to Evaluate the Potential of Dexmedetomidine in Attenuating the Pressor Response and the Quality of Intubation during Laryngoscopy

Attenuating the Pressor Response and the Quality of Intubation during Laryngoscopy

  • Neha Varhney Department of Anesthesiology, Saraswati Medical College, Unnao (U.P) India, 209859
  • Tapan Agrawal Park Hospital, Gurugram, Haryana, India, 122001
  • Roma Sharma Mata Chanan Devi Hospital, C-1, Janakpur, New Delhi – 110058
  • Sanjeev Kumar Nangia Shroff Eye Centre, A-7, Kailash Colony Road, Block – A, Kailash Colony, Greater Kailash, New Delhi, 110048
  • Pramod Mangwana Senior Consultant & Head, Department of Anaesthesiology, Mata Chanan Devi Hospital, C-1, Janakpur, New Delhi – 110058
Keywords: Tachycardia, hypertension, pressor response, laryngoscopy, intubation

Abstract

Background: Onset of hemodynamic changes is often associated with procedures such as laryngoscopy and tracheal intubation. This poses an increased risk of fatality in high-risk patients with diseases such as cardiovascular diseases. Several attempts utilizing singular parameters have been used to combat this clinical manifestation. In this study, we have used a holistic approach, in combination with the pre-recommended parameters, to attenuate the pressor responses during the procedure. Subjects and Methods: Sixty adult patients were randomized into two groups, receiving two different doses of dexmedetomidine (0.5 µg or 1 µg) per kilogram of the bodyweight. In addition, the quality of the intubation was also assessed using the scoring system adapted from McNeil et al., 2000. Longitudinal monitoring of various physiological parameters such as systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), heart rate (HR) and O2 saturation (SpO2) was performed at four different time points during the procedure. Results: Our results revealed that dexmedetomidine administration results in a transient decrease in these parameters in the patients from both the groups, with more prominent effects in the Group I patients, received 1 µg/kg of dexmedetomidine. Moreover, at time-point T3 (60 sec after intubation), a transient increase was observed in almost all the tested parameters. The assessment of the intubating conditions revealed no significant differences among the groups. Conclusion: A higher dosage of dexmedetomidine (1 µg/kg) showed better management of hemodynamic responses during laryngoscopy and intubation.

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Published
2020-07-06
How to Cite
Neha Varhney, Tapan Agrawal, Roma Sharma, Nangia, S. K., & Mangwana, P. (2020). Systematic Approach to Evaluate the Potential of Dexmedetomidine in Attenuating the Pressor Response and the Quality of Intubation during Laryngoscopy. Academia Anesthesiologica International, 5(1), 156-161. Retrieved from http://aijournals.com/index.php/aan/article/view/1605