Rakhi, S P (2015) A Study on the effects of Intravenous Dexmedetomidine on the Haemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation during General Anaesthesia. Masters thesis, Sree Mookambika Institute of Medical Sciences, Kulasekharam.
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Abstract
BACKGROUND AND OBJECTIVES: During induction of general anaesthesia, hypertension and tachycardia caused by endotracheal intubation may lead to cardiac ischemia and arrhythmias. Dexmedetomidine attenuates the hemodynamic response to endotracheal intubation and reduces anaesthetic requirement. The purpose of this study was to evaluate the effect of intravenous dexmedetomidine 1μg/kg given over 10 minutes before induction of anaesthesia and 0.4mcg/kg/hour as maintenance during the surgery, on haemodynamic stress response resulting from laryngoscopy and endotracheal intubation and the haemodynamic stability during surgery. MATERIALS AND METHODS: Seventy patients scheduled for elective surgery were randomized into two groups each having thirty five patients-dexmedetomidine group (Group 1) and control group (Group 2). Heart rate, systolic blood pressure, and diastolic blood pressure were recorded at just before intubation, immediately after intubation, 1, 2, 3, 4, 5 minutes after intubation followed by every 5 minutes till the first 45 minutes of surgery. Anaesthesia was induced with inj.Propofol 2mg/kg IV followed by succinyl choline 2mg/kg for endotracheal intubation. Anaesthesia was maintained with oxygen, nitrous oxide, isoflurane, atracurium. Any further need for analgesia was supplemented by IV fentanyl. STATISTICAL ANALYSIS: The data was analysed by SPSS 16.0 with independent t-test. RESULTS: Pretreatment with dexmedetomidine 1 ug/kg attenuated the cardiovascular and catecholamine responses to tracheal intubation after induction of anaesthesia. In our present study, the rise in heart rate, systolic blood pressure and diastolic blood pressure after intubation, 1, 2, 3, 4, 5 and 10 minutes after intubation was significantly less in the dexmedetomidine group. The patients in dexmedetomidine group also had better haemodynamic stability during surgery. The requirement of opioids and isoflurane were significantly less in the dexmedetomidine group. CONCLUSIONS: Intravenous dexmedetomidine significantly attenuates sympathoadrenal response to laryngoscopy and endotracheal intubation and also cause reduction in intra operative anaesthetic requirement, without affecting intraoperative cardiovascular stability.
| Item Type: | Thesis (Masters) |
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| Additional Information: | Dexmedetomidine ; endotracheal intubation ; premedication ; sedation ; α2 adrenergic. |
| Subjects: | MEDICAL > Anaesthesiology |
| Depositing User: | Punitha K |
| Date Deposited: | 07 May 2018 06:26 |
| Last Modified: | 07 May 2018 06:26 |
| URI: | http://repository-tnmgrmu.ac.in/id/eprint/7613 |
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