An Observational Study of Intravenous Dexmedetomidine and Clonidine for Attenuating Haemodynamic Response to Laryngoscopy and Intubation in Patients Undergoing General Anaesthesia

Authors

  • Priya Kishnani
  • Sanam Shah
  • Jayshri Desai
  • Anuja Agrawal

DOI:

https://doi.org/10.37506/ijfmt.v15i3.15898

Keywords:

Dexmedetomidine, Clonidine, haemodynamic response, laryngoscopy, intubation, general anaesthesia

Abstract

Background: Laryngoscopy and endotracheal intubation alters cardiovascular physiology causing
hypertension and tachycardia. Dexmedetomidine, an alpha 2 adrenergic receptor produces analgesia
by direct activation of descending inhibitory pain pathway and inhibiting the release of substance P.
Clonidine a centrally acting alpha 2 adrenergic agonist decreases central sympathetic nervous system in all
hyperadrenergic situations. Hence we compare haemodynamic effects between dexmedetomidine 0.5 mcg/
kg and clonidine 1mcg/kg during after laryngoscopy and tracheal intubation for patients undergoing general
anaesthesia.
Method: Patients were allocated randomly into 2 groups of 30 each. Group D received dexmedetomidine
0.5mcg/kg diluted in 10ml NS and group C- clonidine 1 mcg/kg diluted in 10ml NS intravenously and
hemodynamic parameters were observed. Dexmedetomidine/ Clonidine according to groups is given
intravenously with premedication. After 5 minutes patients were induced with 2.5% thiopentone 5-7 mg/kg
and succinyl choline 2mg/kg and intubated with appropriate sized cuffed ETT. Anaesthesia was maintained
with O2, N2O, isoflurane and vecuronium bromide 0.08mg/kg.
Results: Haemodynamic changes after laryngoscopy and intubation were recorded at baseline, premedication,
induction, intubation, 1, 3, 5,10 and 15 minutes. The initial fall in HR is more in Group C compared to Group
D but the difference was insignificant, but since intubation till 10min post intubation HR was significantly
(p<0.05) supressed more in Group D. Similarly fall in SBP and DBP is significantly (p<0.05) more in Group
D compared to Group C.
Conclusion: Dexmedetomedine 0.5 mcg/kg intravenously 15 minutes prior to laryngoscopy and intubation
attenuates the sympathetic response better as compared to clonidine without major side effects.

Author Biographies

Priya Kishnani

Background: Laryngoscopy and endotracheal intubation alters cardiovascular physiology causing
hypertension and tachycardia. Dexmedetomidine, an alpha 2 adrenergic receptor produces analgesia
by direct activation of descending inhibitory pain pathway and inhibiting the release of substance P.
Clonidine a centrally acting alpha 2 adrenergic agonist decreases central sympathetic nervous system in all
hyperadrenergic situations. Hence we compare haemodynamic effects between dexmedetomidine 0.5 mcg/
kg and clonidine 1mcg/kg during after laryngoscopy and tracheal intubation for patients undergoing general
anaesthesia.
Method: Patients were allocated randomly into 2 groups of 30 each. Group D received dexmedetomidine
0.5mcg/kg diluted in 10ml NS and group C- clonidine 1 mcg/kg diluted in 10ml NS intravenously and
hemodynamic parameters were observed. Dexmedetomidine/ Clonidine according to groups is given
intravenously with premedication. After 5 minutes patients were induced with 2.5% thiopentone 5-7 mg/kg
and succinyl choline 2mg/kg and intubated with appropriate sized cuffed ETT. Anaesthesia was maintained
with O2, N2O, isoflurane and vecuronium bromide 0.08mg/kg.
Results: Haemodynamic changes after laryngoscopy and intubation were recorded at baseline, premedication,
induction, intubation, 1, 3, 5,10 and 15 minutes. The initial fall in HR is more in Group C compared to Group
D but the difference was insignificant, but since intubation till 10min post intubation HR was significantly
(p<0.05) supressed more in Group D. Similarly fall in SBP and DBP is significantly (p<0.05) more in Group
D compared to Group C.
Conclusion: Dexmedetomedine 0.5 mcg/kg intravenously 15 minutes prior to laryngoscopy and intubation attenuates the sympathetic response better as compared to clonidine without major side effects.

Sanam Shah

Third year Resident, Department of Anaesthesiology, Dhiraj Hospital, Smt.B.K.Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, An Institution Deemed to be University, Vadodara, Gujarat, India

Jayshri Desai

Professor, Department of Anaesthesiology,Dhiraj Hospital,Smt.B.K.Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, An Institution Deemed to be University, Vadodara, Gujarat, India

Anuja Agrawal

Associate Professor,Department of Anaesthesiology,Dhiraj Hospital,Smt.B.K.Shah Medical Institute and Research Centre, Sumandeep Vidyapeeth, An Institution Deemed to be University, Vadodara, Gujarat, India

Published

2021-05-17

How to Cite

Kishnani, P. ., Shah, S. ., Desai, J. ., & Agrawal, A. . (2021). An Observational Study of Intravenous Dexmedetomidine and Clonidine for Attenuating Haemodynamic Response to Laryngoscopy and Intubation in Patients Undergoing General Anaesthesia. Indian Journal of Forensic Medicine & Toxicology, 15(3), 3868-3874. https://doi.org/10.37506/ijfmt.v15i3.15898