Comparative Study Between Intravenous Lignocaine & Intravenous Dexmedetomidine For Attenuation of Hemodynamic Response to Laryngoscopy and Endotracheal Intubation
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Keywords
Dexmedetomidine, Lignocaine, Hemodynamic response, Laryngoscopy, Endotracheal intubation, Blood pressure, Heart rate etc.
Abstract
Laryngoscopy and endotracheal intubation are essential components of General Anaesthesia but are associated with a sympathetic surge, resulting in significant hemodynamic changes such as tachycardia and hypertension. These transient changes, although often well tolerated in healthy individuals, may pose serious risks in patients with cardiovascular or cerebrovascular comorbidities. Various pharmacological agents have been used to blunt this response, among which dexmedetomidine and lignocaine are frequently employed. This study aimed to compare the efficacy of intravenous lignocaine and intravenous dexmedetomidine in attenuating the hemodynamic responses to laryngoscopy and endotracheal intubation in adult patients undergoing elective surgeries under General Anaesthesia.
Materials and Methods:
A prospective, randomized, clinical study was conducted at ICARE Institute of Medical Sciences and Research & Dr. B. C. Roy Hospital, Haldia, West Bengal, over a one-year period from July 2023 to June 2024. A total of 100 patients (ASA I & II), aged 18–60 years, were randomly divided into two groups: Group L received intravenous lignocaine (1.5 mg/kg, 3 minutes before intubation) while Group D received intravenous dexmedetomidine (1 µg/kg over 10 minutes before induction). Hemodynamic parameters such as heart rate (HR), systolic blood pressure (SBP), and mean arterial pressure (MAP) were recorded at baseline, induction, intubation, and at 1, 3, 5, and 10 minutes post-intubation.
Results:
Group D (Dexmedetomidine) showed a statistically significant attenuation of heart rate, systolic blood pressure and mean arterial pressure at induction and during the first five minutes post-intubation compared to Group L (Lignocaine), with p-values <0.001 across most time points. At intubation, the mean heart rate in Group D was 72.58 bpm versus 84.28 bpm in Group L, and mean SBP was 104.70 mmHg in Group D versus 120.16 mmHg in Group L. MAP values followed a similar trend, with Group D demonstrating consistently lower readings. No severe bradycardia, hypotension, or delayed emergence was noted in either group. The dexmedetomidine group also showed a smoother anesthetic induction and better peri-intubation cardiovascular stability, reinforcing its efficacy and safety profile in mitigating intubation-induced stress responses.
Conclusion:
Dexmedetomidine is significantly more effective than lignocaine in attenuating the hemodynamic response to laryngoscopy and intubation, making it a safer and more reliable choice, especially in patients at cardiovascular risk.
References
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Dr Sahanaj Parvin
Post Graduate Trainee, Department of Anaesthesiology, ICARE Institute of Medical Sciences and Research & DR B C Roy Hospital, Haldia West Bengal 721645
Dr Diptanu Bhaumik
Assistant Professor, Department of Anaesthesiology, ICARE Institute of Medical Sciences and Research & DR B C Roy Hospital
Dr Arup Dasgupta
Professor and HOD, Department of Anaesthesiology, ICARE Institute of Medical Sciences and Research & DR B C Roy Hospital