A Comparative Study on Attenuation of Stress Response During Direct Laryngoscopy and Endotracheal Intubation with Dexmedetomidine and Lignocaine in Central Kerala

Abstract

BACKGROUND Direct laryngoscopy and endotracheal intubation have been a part of the mainstay modalities of providing anaesthesia. Both lignocaine and dexmedetomidine have proven effects of attenuating the stress response to laryngoscopy and intubation. This study compared the efficacy in attenuating the pressor response of lignocaine when given at 1.5 mg/kg and dexmedetomidine given at 0.5 µg/kg body weight. METHODS This is a prospective observational study involving 80 patients of both sexes who underwent elective surgeries under general anaesthesia. They were divided into two groups: Group D and Group L. Group D received dexmedetomidine 0.5 µg/kg body weight slow IV, 10 minutes prior to laryngoscopy and Group L received 2% preservative free lignocaine 1.5 mg/kg body weight i.v. bolus ninety seconds prior to laryngoscopy. Hemodynamic changes like heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean blood pressure (MBP) were monitored before induction (baseline), post induction and at 1, 5, and 10 minutes after endotracheal intubation. Structured proforma was formulated and obtained data was analysed using STATA software. RESULTS In the lignocaine group, heart rate, SBP, DBP and MAP increased and gradually returned to baseline value. The dexmedetomidine group showed highly significant attenuation of sympathetic response to laryngoscopy and intubation compared to lignocaine groups. CONCLUSIONS The study results go on to demonstrate that dexmedetomidine infusion is better at attenuating the pressor response to intubation than preservative free intravenous lignocaine when given prior to induction. KEY WORDS Stress Response, Direct Laryngoscopy, Intubation, Dexmedetomidine, Lignocaine.