Prevention of Pressor response to Laryngoscopy: A Comparison of Lignocaine with Dexmedetomidine
DOI:
https://doi.org/10.51985/JBUMDC2023177Keywords:
Dexmedetomidine, Laryngoscopy, Lignocaine, Pressor responseAbstract
Objective: To compare intravenous Lignocaine with Dexmedetomidine for prevention of pressor response to laryngoscopy.
Study design and setting: Randomized Clinical Trial at Anesthesia Department, RIHS Islamabad. (1st May2019 To 30th
October 2019)
Methodology: 68 patients with age 20-60 years, ASA status(I or II), planned for elective surgeries under GA were included
in this study and randomly divided into groups A and B by lottery method. Patients with history of hypertension, heart
blocks, beta-blockers were excluded from study. Group-A patients were given injection Lignocaine 2% 1mg/kg 1min before
induction and Group-B patients were given injection Dexmedetomidine 1ug/kg 15 min before induction of anesthesia.
After premedication with injection Midazolam, Nalbuphine, and Ondansetron, Induction of anesthesia was done with
injection Propofol and Cisatracurium. Patients were intubated. Use of stylet,BURP maneuver, incidence of laryngospasm
was noted. Vitals before and after intubation were noted.
Results: There was no significant difference in demographic profile,use of a stylet, BURP maneuver and laryngospasm
in both groups. ANOVA test shows significant decrease in change in Systolic BP in Dexmedetomidine group at 2 and 3
minutes after intubation as compared to Lignocaine group however Diastolic BP and Heart rate was comparable in both
groups. Paired t test showed a significant decrease in Systolic and Diastolic BP in both groups( more in Dexmedetomidine
group).Regarding heart rate paired t test showed insignificant difference in Lignocaine group and significant difference
in Dexmedetomidine group.
Conclusion: Intravenous Dexmedetomidine is superior to Lignocaine to prevent pressor response to laryngoscopy
References
Deo GP, Gautam S, Shrestha IN, Regmi BS, Shrestha S,
Yadav NK. Hemodynamic responses to laryngoscopy and
intubation using Macintosh, Miller and McCoy blades. JCMC
;9(4):47-51. DOI:10.3126/jcmc.v9i4.26901
Misganaw A, Sitote M, Jemal S, Melese E, Hune M, Seyoum
F, Sema A, Bimrew D. Comparison of intravenous magnesium
sulphate and lidocaine for attenuation of cardiovascular
response to laryngoscopy and endotracheal intubation in
elective surgical patients at Zewditu Memorial Hospital Addis
Ababa, Ethiopia. PloS one. 2021;16(6):e0252465. doi:
1371/journal.pone.0252465
Lakhe G, Pradhan S, Dhakal S. Hemodynamic response to
laryngoscopy and intubation using McCoy laryngoscope: a
descriptive cross-sectional study. JNMA: Journal of the Nepal
Medical Association. 2021;59(238):554-557. doi: 10. 31729
/jnma.6752.
Safavi M, Honarmand A. Attenuation of cardiovascular
responses to laryngoscopy and tracheal intubation. MEJ
Anest. 2008;19(6):1349-60.
Gotiwale K, Lele S, Setiya S. Stress response to laryngoscopy
and ease of intubation: Comparison between macintosh and
(levering) McCoys type laryngoscope. Int J Res Med Sci.
;4(8):3141-45. doi: 10.18203/2320-6012.
Hajian P, Sharifi S, Nikooseresht M, Moradi A. The effects
of intravenous nitroglycerin bolus doses in reducing
hemodynamic responses to laryngoscopy and endotracheal
intubation. BioMed Research International. 2021;2021:1-
doi: 10.1155/2021/6694150
Mulimani SM, Talikoti DG, Vastrad VV, Sorganvi VM.
Efficacy of a Bolus Dose of Esmolol and Bolus Dose of
Lignocaine for Attenuating the Pressor Response to
Laryngoscopy and Endotracheal Intubation in General
Anesthesia: A Comparative Study. Anesth Essays Res. 2019
;13(2):292-296. doi: 10.4103/aer.AER_31_19.
Suryawanshi C, Ravindran DG, Pati Sathvika D, Jawale R.
Efficacy Of Preoperative Dexmedetomidine Nebulization On
Blunting The Hemodynamic Response To Laryngoscopy And
Intubation. Journal of Pharmaceutical Negative Results. 2022
:4196-205.
Catterall WA, Mackie K. Local Anesthetics. In: Brunton L,
Chabner B, Knollman B, editors. Goodman and Gilman's
The Pharmacological Basis of Therapeutics. 12th ed. New
York: McGraw Hill Publishers; 2011. 564–82.
Lee S. Dexmedetomidine: present and future directions.
Korean journal of anesthesiology. 2019 ;72(4):323-30.doi:
4097/kja.19259.
Morgan GE, Mikhail MS. Morgan & Mikhail's clinical
anesthesiology. McGraw-Hill Education. 2018; 18:523
Gulabani M, Gurha P, Dass P, Kulshreshtha N. Comparative
analysis of efficacy of lignocaine 1.5 mg/kg and two different
doses of dexmedetomidine (0.5 ìg/kg and 1 ìg/kg) in attenuating
the hemodynamic pressure response to laryngoscopy and
intubation. Anesthesia, essays and researches. 2015 ; 9(1):
–14. DOI: 10.17511/IJMRR.2019.I05.01
Ongewe A, Mung’ayi V, Bal R. Effect of low-dose ketamine
versus fentanyl on attenuating the haemodynamic response
to laryngoscopy and endotracheal intubation in patients
undergoing general anaesthesia: a prospective, double-blinded,
randomised controlled trial. African Health Sciences. 2019
;19(3):2752-63. doi: 10.4314/ahs.v19i3.51
Imani F, Zaman B, De Negri P. Postoperative pain
management: Role of dexmedetomidine as an adjuvant.
Anesthesiology and Pain Medicine. 2021 Jan 2;10(6):e112176.
doi: 10.5812/aapm.112176.
Hussain SY, Karmarkar A, Jain D. Evaluation and Comparison
of Clonidine and Dexmedetomidine for Attenuation of
Hemodynamic Response to Laryngoscopy and Intubation: A
Randomized Controlled Study. Anesth Essays Res. 2018
;12(4):792-796. doi: 10.4103/aer.AER_123_18.
Jamal AR, Yasin B, Saeed M, Khan RA, Ali Shah S, Akbar
M. Evaluation of dexmedetomidine on hemodynamic stress
response during laryngoscopy and intubation. PAFMJ .2021;
(6):2126-30. doi.org/10.51253/pafmj.v71i6.6584
Kumar NR, Jonnavithula N, Padhy S, Sanapala V, Naik VV.
Evaluation of nebulised dexmedetomidine in blunting
haemodynamic response to intubation: A prospective
randomised study. Indian Journal of Anaesthesia. 2020
Oct;64(10):874-879. DOI: 10.4103/ija.IJA_235_20
Boksh SZ. Faruquzzaman (2020) Intravenous use of
Dexmedetomidine for Attenuation of Hemodynamic Stress
Response to Laryngoscopy and Endotracheal Intubation in
Contrast to Intravenous Lignocaine. Arch Clin
Gastroenterol.2020;6(3):077-81. DOI: 10.17352/2455-
000085
Seangrung R, Pasutharnchat K, Injampa S, Kumdang S,
Komonhirun R. Comparison of the hemodynamic response
of dexmedetomidine versus additional intravenous lidocaine
with propofol during tracheal intubation: a randomized
controlled study. BMC anesthesiology. 2021;21(1):265. DOI:
1186/s12871-021-01484-6
Chauhan K, Chatterji C, Prajapati RK, Gupta A. Comparison
of Dexmedetomidine, Fentanyl and Lignocaine in Attenuation
of Haemodynamic Response to Direct Laryngoscopy and
Intubation. IOSR-JDMS. 2018;17(1): 01-06.
Silpa AR, Koshy KA, Subramanian A, Pradeep KK.
Comparison of the efficacy of two doses of dexmedetomidine
in attenuating the hemodynamic response to intubation in
patients undergoing elective cardiac surgery: a randomized
double-blinded study. Journal of Anaesthesiology, Clinical
Pharmacology. 2020;36(1):83-87. doi: 10.4103/joacp. JOACP
_235_18.
Downloads
Published
How to Cite
Issue
Section
License
Copyright (c) 2023 Ayesha Shahid, Muhammad Salman Maqbool, Sidra Shabbir, Fahd Mudassar Hameed, Nargis Shabana, Fareeha Tayyab
This work is licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.
Journal of Bahria University Medical & Dental College is an open access journal and is licensed under CC BY-NC 4.0. which permits unrestricted non commercial use, distribution and reproduction in any medium, provided the original work is properly cited. To view a copy of this license, visit https://creativecommons.org/licenses/by-nc/4.0