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Efficacy of two different doses of nebulized dexmedetomidine for attenuation of hemodynamic response to laryngoscopy and intubation: A randomized controlled trial

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Original Article

Author Details : Amit Pradhan, Soumya Ranjan Sahoo, Rajendra Kumar Sahoo, Laxman Kumar Senapati*, Priyadarsini Samanta

Volume : 12, Issue : 1, Year : 2025

Article Page : 28-35

https://doi.org/10.18231/j.ijca.2025.005

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Abstract

Background Laryngoscopy and intubation cause augmented sympathoadrenal activity leading to hemodynamic alterations elicited by tachycardia and hypertension. Various drugs have been tried by multiple routes to attenuate the stress response, but none of them proved to be ideal. Dexmedetomidine nebulization at 1 mcg/kg used for negating this stress response resulted in a considerable drop in heart rate (HR) and blood pressure after induction of anesthesia. Hence, we intended to use dexmedetomidine at a lower dose and compare its efficacy with the conventional dose of 1mcg/kg in providing stable hemodynamics.


Materials and Methods: 100 patients scheduled for elective surgeries under general endotracheal anesthesia were randomized into group DA [received pre-operative dexmedetomidine nebulization at a dose of 1 mcg/kg] and group DB [received preoperative dexmedetomidine nebulization at a dose of 0.75 mcg/kg]. The HR, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded before nebulization, after nebulization, and at 1-, 3-, 5-, and 10-minute post?intubation. The induction dose of propofol, incidence of postoperative nausea and vomiting (PONV), and sore throat were also noted.


Results: A statistically significant reduction was seen in SBP after nebulization (p= 0.030) and at 10 minutes post-intubation (p=0.006) in group DA compared to group DB. DBP in group DA was decreased significantly post-nebulization (p=0.001) at one-minute post-intubation (p=0.014), at three minutes post-intubation (p=0.028), and after ten minutes post-intubation (< p=0.001). Group DA showed a significantly lower MAP compared to group DB after nebulization (p=0.003), one-minute post-intubation (p=0.040), and ten minutes after intubation (< p=0.001). No statistically significant difference was seen in the attenuation of HR, reduction of induction dose of propofol, and reduction in the incidence of PONV between the two groups.


Conclusion: Nebulized dexmedetomidine at a dose of 0.75 µg/kg effectively diminishes the stress response to laryngoscopy and intubation with better hemodynamic stability than the conventional dose of 1 µg/kg.

How to cite : Pradhan A, Sahoo S R, Sahoo R K, Senapati L K, Samanta P, Efficacy of two different doses of nebulized dexmedetomidine for attenuation of hemodynamic response to laryngoscopy and intubation: A randomized controlled trial. Indian J Clin Anaesth 2025;12(1):28-35

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