An evaluation of haemodynamic responses to tracheal intubation following intravenous dexmedetomidine and fentanyl in patients undergoing laparoscopic cholecystectomy
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Keywords
Fentanyl, Dexmedetomidine, Cholecystectomy, Haemodynamic response., Tracheal intubation
Abstract
Background: Laryngoscopy and tracheal intubation are related to sympathetic stimulation and lead to hypertension and tachycardia. These changes in hemodynamics may increase the risk of myocardial ischemia. As a result, effective blunting of these unpleasant responses is required. This study aimed to compare the effects of dexmedetomidine and fentanyl bolus administration on the attenuation of hemodynamic response to tracheal intubation in patients undergoing laparoscopic cholecystectomy surgeries.
Methodology: A total of 136 patients of both genders undergoing elective laparoscopic cholecystectomy surgeries satisfying inclusion criteria were randomly allocated into 2 groups (group D and group F). Group D received 1mcg/Kg of dexmedetomidine (Dexa) intravenous (IV) in 100ml of normal saline over 10 minutes and 5ml of normal saline over 3 minutes before induction. Group F received Inj. Fentanyl 2mcg/Kg diluted in 100 ml of normal saline over 10 minutes and 5ml of normal saline 3 minutes before induction. The patients were ventilated for 3 minutes by bag and mask. After 3 minutes of ventilation, endotracheal intubation was done. Vitals (systolic blood pressure, diastolic blood pressure, mean arterial blood pressure, heart rate) were recorded from the time of intubation to 10 minutes after that at 1-minute intervals.
Results: In both groups, heart rate increased significantly immediately following intubation (p = 0.002). In the dexmedetomidine group heart rate, mean arterial pressure, and systolic and diastolic blood pressures were significantly controlled at various time points in comparison to the fentanyl group after laryngoscopy and intubation.
Conclusions: Dexmedetomidine in a dose of 1mcg/kg causes greater and sustained attenuation of haemodynamic response to endotracheal intubation among the patients of cholelithiasis undergoing laparoscopic cholecystectomy surgeries as compared to fentanyl. Therefore, it can be used as an effective alternative to opioids for the induction of general anaesthesia in patients undergoing laparoscopic cholecystectomy surgery.
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