Comparative Study of Dexmedetomidine and Fentanyl for Attenuation of Hemodynamic Response to Laryngoscopy and Intubation

Abstract

Background: Laryngoscopy and intubation cause hypertension and tachycardia which can lead to myocardial ischemia or cerebrovascular hemorrhage in patients with raised intracranial pressure, hypertension. The objective of this study was to compare the efficacy of dexmedetomidine (1 mcg/kg) and fentanyl (2 mcg/kg) in attenuating hemodynamic response to laryngoscopy and intubation.
 Methods: Sixty patients scheduled for elective surgeries under general anaesthesia were randomly divided into two groups: Group D and Group F. Group D received dexmedetomidine 1 mcg/kg and group F received fentanyl 2 mcg/kg intravenously over 10 min prior to induction of anesthesia. All the drugs and techniques of anesthesia were standardized in patients in both the groups. Heart rate, systolic, diastolic and mean arterial pressure were recorded at following intervals: at baseline, after drug administration (at 2 and 5 min), after induction, and at 1, 2 and 5 min after intubation.
 Results: Heart rate and blood pressure was found to be significantly lower in dexmedetomidine group as compared to fentanyl group at 1, 2 and 5 min after intubation.
 Conclusions: Dexmedetomidine 1 mcg/kg is superior to fentanyl 2 mcg/kg for attenuation of hemodynamic response to laryngoscopy and intubation.

Comparison of Fentanyl and Dexmedetomidine in Preventing an Increase in Heart Rate During Intubation Among Patients Undergoing General Anesthesia: A Meta-Analysis

“…Only one study compared fentanyl, dexmedetomidine, and lidocaine [11]. All other studies have compared only fentanyl and dexmedetomidine [12][13][14][15][16][17][18]. In this meta-analysis, lidocaine was ignored, as the aim of this meta-analysis was to compare fentanyl and dexmedetomidine.…”

“…neurosurgical procedure [12], and cardiac surgery [18]. All other studies included all kinds of elective surgical procedures [13][14][15][16][17]. Two reviewers assessed the risk of bias and it was found to be perfectly consistent, which showed that the overall quality of the study was moderate.…”

“…All eight studies reported HR at baseline [11][12][13][14][15][16][17][18]. The meta-analysis results showed no significant difference in HR between the two groups at baseline (MD = 1.48; 95% CI: -0.84, 3.81; P = 0.21, I 2 = 53%), as shown in Figure 3.…”

“…The meta-analysis results showed no significant difference in HR between the two groups at baseline (MD = 1.48; 95% CI: -0.84, 3.81; P = 0.21, I 2 = 53%), as shown in Figure 3. Source: [11][12][13][14][15][16][17][18].…”

“…Six studies compared the HR between dexmedetomidine and fentanyl after one minute of intubation [13][14][15][16][17][18].…”