Key result
Dexmedetomidine significantly attenuated the rise in heart rate at intubation compared to clonidine (4.70% vs 9.59% rise; p<0.05).
Why the study?
Does Dexmedetomidine 1 µg/kg IV attenuate hemodynamic responses to endotracheal intubation better than Clonidine 1 µg/kg IV in patients undergoing elective surgeries under general anesthesia?
RCT (n=60)
Double-blind
Randomized
Does Dexmedetomidine 1 µg/kg IV attenuate hemodynamic responses to endotracheal intubation better than Clonidine 1 µg/kg IV in patients undergoing elective surgeries under general anesthesia?
Dexmedetomidine 1 µg/kg IV is more effective than Clonidine 1 µg/kg IV in attenuating the sympathetic hemodynamic response to laryngoscopy and intubation.
Answers are grounded in this paper and cite their sources.
Dexmedetomidine may blunt intubation hemodynamics more than clonidine; leaves open optimal dosing and practice change pending larger trials.
Objectives: To compare the effects of Dexmedetomidine (1g/kg) and Clonidine (1g/kg) on hemodynamic responses to endotracheal intubation, effect on anaesthetic requirements and effect on sedation. Material and Methods: In this prospective double-blind study, 60 patients scheduled for elective surgeries under general anesthesia were randomly divided into two groups Group D ( Inj. Dexmedetomidine dose 1?g/kg iv) and Group C ( Inj. Clonidine dose 1?g/kg iv). Patients belonging to ASA I and ASA II of both sexes aged 20-60 years, were included in this comparative randomized study. Pulse, blood pressure, ECG were monitored continuously and recorded before giving the study drug , after giving the study drug , at intubation then at1,3,5,10 minutes after intubation. Data were analysed and p 0.05 was considered significant. Result: Dexmedetomidine group had 4.70% rise in heart rate at time of intubation and Clonidine group had 9.59% rise which was statistically significant(p 0.05), except during intubation, difference in heart rate between two groups was not significant.(p>0.05)) Group C had significant rise in SBP and DBP during intubation compared to Group D. Maximum rise in SBP and DBP in Group C was 14.53% and 12.84% respectively, whereas in Group D it was 5.55% and 8.90% respectively. Dexmedetomidine group had better sedation than Clonidine group.(p 0.05) Conclusion: Dexmedetomidine significantly attenuated the sympathetic response of laryngoscopy and intubation as compared to Clonidine.
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Arora et al. (2014) conducted an RCT in Elective surgeries under general anesthesia (n=60). Dexmedetomidine vs. Clonidine 1µg/kg iv was evaluated on Rise in heart rate at time of intubation (p=<0.05). Dexmedetomidine significantly attenuated the rise in heart rate at intubation compared to clonidine (4.70% vs 9.59% rise; p<0.05).
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