Key result
Dexmedetomidine significantly attenuated the hemodynamic stress response during laryngoscopy and intubation, maintaining a lower mean systolic blood pressure (122.42 vs 155.00 mmHg) compared to placebo.
Why the study?
Does dexmedetomidine reduce the hemodynamic stress response during laryngoscopy and intubation in surgical patients?
RCT (n=100)
Double-blind
Computer-generated random numbers
No
Does dexmedetomidine reduce the hemodynamic stress response during laryngoscopy and intubation in surgical patients?
Absolute Event Rate: 122.42% vs 155%
p-value: p=<0.001
Dexmedetomidine effectively blunts the hemodynamic stress response, including tachycardia and hypertension, associated with laryngoscopy and endotracheal intubation.
May blunt intubation hemodynamics in this cohort; leaves open need for RCTs to guide practice.
Objective: To compare the efficacy of Dexmedetomidine (Precedex) in addressing the mean haemodynamic stress response to laryngoscopy and endotracheal intubation (L&I). Study Design: Quasi-experimental study. Place and Duration of Study: Anesthesiology Department, Combined Military Hospital, Rawalpindi, from Jun 2019 Jun 2020. Methodology: The patients were divided into two groups. Group A was given Inj. Dexmedetomidine and group B (placebo). Operation theatre assistant randomly assigned the patients to either group A or group B each day. The second person administered the drug or placebo. The third person (researcher) recorded all the parameters mentioned in the proforma. Results: There were 100 patients with an age range of 18-60 years. The majority of the patients were ASA-I physical status. The main surgical procedure was laparoscopic cholecystectomy. Recording of heart rate and systolic blood pressure during laryngoscopy and intubation, after administration of drug or placebo, showed mean heart rate less than mean basal value in group-A and 22% above mean basal value in group-B, and it was statistically highly significant (p-value <0.001). Whereas mean systolic blood pressure in group-A was 122.42 ± 14.91 (less than the mean basal value) as compared to group B, 155.00 ± 18.32/min (20% above mean basal value). This change was also statistically highly significant (p-value <0.001). Conclusion: It is concluded that dexmedetomidine showed statistically significant stabilizing effects on the expected changes of the hemodynamic stress response.
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Jamal et al. (2021) conducted an RCT in Elective surgery requiring endotracheal intubation (n=100). Dexmedetomidine vs. Placebo (normal saline) was evaluated on Mean systolic blood pressure during laryngoscopy and intubation (p=<0.001). Dexmedetomidine significantly attenuated the hemodynamic stress response during laryngoscopy and intubation, maintaining a lower mean systolic blood pressure (122.42 vs 155.00 mmHg) compared to placebo.
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