Attenuation of Hemodynamic Response to Tracheal Intubation with Pregabalin and Dexmedetomidine - A Prospective Randomized Double Blinded Study

Abstract

Objective: Airway manipulation during endotracheal intubation is a potential stimulus and it is associated with untoward hemodynamic changes. The aim of this study was to compare the efficacy of intravenous dexmedetomidine and oral pregabalin premedication for attenuation of hemodynamic pressor response to laryngoscopy and intubation. Methods: A total of 60 patients of age group of 18-60 years scheduled for elective surgeries under general anesthesia with ASA physical status I were randomized into two groups. Group D received intravenous dexmedetomidine at a dose of 1 µg kg-1 over 10 minutes before induction and group P received oral pregabalin 150 mg one hour prior to intubation. The primary outcomes, heart rate and mean arterial pressure noted at serial intervals during intubation were compared between the groups. Sedation score was assessed as secondary outcome using Richmond Agitation Sedation Scale Scores (RAAS). Results: Group D and P were comparable with distribution of age, sex and duration of laryngoscopy. The mean heart rates and mean arterial pressures assessed at serial measurements at 0, 1, 3, 5, 10 minutes post-intubation were statistically significant (p=0.005) in dexmedetomidine group when compared to pregabalin group. The RASS scores assessed at 15, 30 and 60 minutes post-extubation were statistically significant (p<0.05) in pregabalin group when compared to dexmedetomidine group. Conclusion: Intravenous dexmedetomidine at a dose of 1 µg kg-1 is more effective than oral pregabalin 150 mg in attenuating hemodynamic response to laryngoscopy and orotracheal intubation. Post-procedural sedation was better achieved with oral pregabalin compared to intravenous dexmedetomidine.