Context:Endotracheal intubation has been suggested to be one of the most invasive stimuli in anesthesia, particularly during induction and after tracheal intubation. The present study aims to evaluate the efficacy of dexmedetomidine as compared to diltiazem on hemodynamic response to laryngoscopy and intubation.Aims:To assess and compare the hemodynamic response of dexmedetomidine as compared to diltiazem in patients undergoing laryngoscopy and intubation and rate and type of side effects of the drugs if any.Settings and Design:This study design was a prospective, randomized, and double-blind trial.Subjects and Methods:The patients were randomly allocated into three groups: Group I (control), Group II (dexmedetomidine), and Group III (diltiazem) of 45 patients each. Group I (n = 45): 0.9% NaCl 10 ml was given to the patients over 10 min before intubation in Group I (control). Group II (n = 45): injection dexmedetomidine (0.5 μg/kg) in 10 ml normal saline was given to the patients over 10 min before intubation. Group III (n = 45): injection diltiazem (0.3 mg/kg) in 10 ml normal saline was given to the patients over 10 min before intubation.Statistical Analysis Used:The data so collected were subjected to statistical analysis using Statistical Package for the Social Sciences version 15.0.Results:Mean percentage increase in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) following intubation was 17.90%, 19.96%, and 19.04%, respectively, in control group, 9.04%, 6.32%, and 7.53%, respectively, in dexmedetomidine group, and 12.30%, 10.32%, and 11.14%, respectively, in diltiazem groups. Statistically, there was a significant difference in postintubation SBP, DBP, and MAP of the three groups (P < 0.001). Dexmedetomidine at a dose of 0.5 μg/kg showed to have a better attenuation of pressor response as compared to diltiazem at a dose of 0.3 μg/kg.Conclusions:Both dexmedetomidine and diltiazem were safe and effective in attenuating the hemodynamic response following laryngoscopy and endotracheal intubation; however, between two trial drugs, dexmedetomidine had a better response.
Background: Effective postoperative pain control is an essential component of the care of the surgical patient. The present study was conducted to compare levobupivacaine 0.5% versus isobaric levobupivacaine 0.5% with 3mcg dexmedetomidine in spinal anaesthesia.Subjects and Methods:The present study was conducted on 80 patients of ASA Grade-I and Grade-II of both genders. They were divided into 2 groups of 40 each. Group I were those who received 3 ml of 0.5% isobaric levobupivacaine with 0.3 ml of normal saline and group II patients received 3 ml of 0.5% isobaric levobupivacaine with 3µg of dexmedetomidine. Parameters such as onset of sensory blockade at T10 dermatome and onset of motor blockade motor blockade, maximum level of sensory and motor blockade attained and the time taken for the same, total duration of sensory blockade and motor blockade were recorded.Results:Group I, ASA grade I was seen in 25 and II in 15, in group II, ASA grade I was seen in 22 and II in 18 patients. Group I comprised of 18 males and 22 females, group II had 20 males and 20 females. Mean duration of surgery in group I was 58.2 minutes in group I and 56.4 minutes in group II. Mean heart rate was 82.3 per minute in group I and 81.6 per minute in group II. The mean time required to obtained sensory block in group I was 10.4 minutes and in group II was 7.4 minutes. The mean time for motor block in group I was 8.2 minutes and in group II was 5.4 minutes. The mean time required to obtain motor block in group I was 16.5 minutes and in group II was 16.1 minutes.Conclusion:Authors found that addition of intrathecal dexmedetomidine to 0.5% isobaric levobupivacaine shortens sensory and motor block onset time and prolongs block duration.
Background: Extubation at light levels of anesthesia or sedation can stimulate reflex responses via tracheal and laryngeal irritation. The present study was conducted to compare dexmedetomidine and fentanyl on airway reflexes and hemodynamic responses to tracheal extubation in nasal surgeries.Subjects and Methods:The present study was conducted on 60 patients of ASA grade I and Grade II of both genders. Patients were divided into 2 groups of 30 each. Group I were dexmedetomidine 0.5 μg/kg in 100 mL of isotonic saline and group II patients received fentanyl 1 μg/kg in 100 mL of isotonic saline intravenously. Parameters such as duration of surgery and duration of anesthesia (minutes) were recorded. Extubation time, awakening time and orientation time was recorded.Results:The ASA grade I was seen in 20 in group I and 14 in group II, ASA grade II was seen in 10 in group I and 16 I group II. Group I comprised of 14 males and 16 females, group II had 17 males and 13 females. Mean duration of surgery in group I was 172.4 minutes and in group II was 174.6 minutes in group II. Mean duration of anesthesia was 194.2 minutes in group I and 198.6 minutes in group II. The difference was non- significant (P> 0.05). The mean extubation time in group I was 7.2 minutes and 5.6 minutes in group II, awakening time was 10.2 minutes in group I and 10.8 minutes in group II and orientation time was 14.3 minutes in group I and 15.2 minutes in group II.Conclusion:Authors found that dexmedetomidine 0.5 μg/kg IV, administered before extubation, was more effective in attenuating airway reflex responses to tracheal extubation as compared with fentanyl 1 μg/kg IV.
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