Dexmedetomidine Versus Oral Pregabalin to Attenuate Hemodynamic Response to Laryngoscopy and Orotracheal Intubation: A Comparative Study

Abstract

Objectives: The airway instrumentation of direct laryngoscopy and tracheal intubation is powerful noxious stimuli that should be attenuated by appropriate premedication, smooth induction, and rapid intubation. This study compared the efficacy 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 20-50 years scheduled for elective surgeries under general anesthesia with American Society of Anesthesiologists physical Status I and II were divided into two groups each of 30. Group D received intravenous dexmedetomidine 1 mcg/kg over 10 minutes before induction, and Group P received oral pregabalin 150 mg 1 hr before intubation. Parameters observed were heart rate (HR) and mean arterial pressure (MAP) at baseline, after induction, immediately after intubation and then 5, 10, 15, and 30 minutes thereafter.Results: Attenuation of HR in group dexmedetomidine (78.12±10.0/minutes) immediately after intubation was statistically significant than group pregabalin (89.76±10.45/minutes). MAP significantly (p<0.05) decreased after intubation with dexmedetomidine. As compared to oral pregabalin, attenuation of HR and MAP was statistically significant till 30 minutes after intubation with intravenous dexmedetomidine. Conclusion:Intravenous dexmedetomidine 1 µg/kg is more effective than oral pregabalin 150 mg in attenuating hemodynamic response to laryngoscopy and orotracheal intubation.

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

“…Our study outcomes were similar to those of Samal et al (5) who compared 1 µg kg -1 dexmedetomidine with 150 mg pregabalin for attenuation of hemodynamic response to endotracheal intubation and found that dexmedetomidine group induced less variation in heart rate and mean arterial pressure as a response to endotracheal intubation than pregabalin group. They assessed heart rate and mean arterial pressure till 30 minutes post-intubation where the response due to surgical stimulus could affect the study.…”

“…After obtaining approval from the hospital ethics committee and written informed consent from the patients, this prospective, double-blind randomized comparative study was performed in 60 ASA (American Society of Anesthesiology) physical status grade I patients, aged between 18-60 years scheduled for elective surgeries performed under general anesthesia requiring endotracheal intubation. Sample size was calculated to be 26 patients per group with a statistical power of 90% and an alpha error of 1% by using Master Software Version 2.0, based on the previous study (5) with the mean heart rate difference of 11, standard deviation of 10 and 10.45. Considering the possibility of dropouts, the size of sample was arbitrarily increased to 60 pati-ents in this study.…”

“…Dexmedetomidine is an imidazole derivative which is a highly selective alpha-2 adrenergic receptor agonist, and is being widely used to attenuate hemodynamic response to direct laryngoscopy (2,3) . Gabapentin and pregabalin a structural analogue of gamma -aminobutyric acid originally introduced as an antiepileptic also has analgesic, anticonvulsant, and anxiolytic effects that helps in attenuation of heart rate and blood pressure following intubation (4,5) . Previous studies proved the effectiveness of dexmedetomidine in attenuating the pressor response to endotracheal intubation but there are limited studies with pregabalin.…”