Effect Of Preoperative Nebulization with Fentanyl and Dexmedetomidineon Cardiovascular Response to Laryngoscopy: A Comparative Analysis

Background: Laryngoscopy and tracheal intubation induce significant hemodynamic changes, which can be det-rimental in patients with cardiovascular or neurological conditions. Various pharmacological agents, includingfentanyl and dexmedetomidine, have been used to mitigate this response. However, limited studies have comparedtheir efficacy when administered via nebulization.Aim: This study aims to evaluate and compare the effectiveness of fentanyl and dexmedetomidine nebulizationin attenuating the hemodynamic stress response to laryngoscopy and intubation.Methodology: A prospective study was conducted at the Department of Anesthesia, Bhagwan Mahavir Instituteof Medical Sciences, Pawapuri, Bihar, India, from October 2023 to October 2024. A total of 85 patients, aged 18–60 years, classified as ASA I and II, were randomized into two groups. Group A received fentanyl nebulization(2 μg/kg), while Group B received dexmedetomidine nebulization (1 μg/kg) before induction. Hemodynamicparameters, including heart rate (HR) and mean arterial pressure (MAP), were recorded at various time points.Statistical analysis was performed using SPSS version 27.Results: Group B exhibited a significantly lower HR at 1, 5, and 10 minutes post-intubation (p < 0.0001). MAPreduction was more pronounced in Group B at 10 minutes (p < 0.0001). Propofol consumption was significantlylower in Group B (p < 0.0001).Conclusion: Dexmedetomidine nebulization demonstrated superior efficacy in blunting hemodynamic responsesto laryngoscopy’ and intubation while reducing anesthetic requirements, suggesting a potential advantage overfentanyl nebulization.