A Comparative Study to Determine the Efficacy of Dexmedetomidine 1mcg/Kg and Labetalol 0.25 Mg/Kg in Attenuating the Hemodynamic Stress Responses to Laryngoscopy and Endotracheal Intubation.

Abstract

Introduction: Hemodynamic fluctuations including hypertension and tachycardia, occur due to manipulation of the larynx and trachea during direct laryngoscopy and endotracheal intubation. These changes primarily arise from reflex sympathetic discharge triggered by stimulation of the laryngotracheal region.

Typically, these responses are transient and variable and are well tolerated by individuals without any underlying pathologies. However, in patients with conditions such as hypertension, coronary artery diseases and intracranial hypertension, these hemodynamic alterations may precipitate severe complications.

Aims and objectives: To compare the efficacy of Dexmedetomidine and Labetalol in attenuating hemodynamic responses during laryngoscopy and endotracheal intubation.

Material and methods: Total 60 patients were randomly allocated in two groups.   Group D (n=30) = received 1 mcg/kg dexmedetomidine diluted to 10 ml of 0.9% normal saline. Group L(n=30) = received 0.25 mg/kg labetalol diluted to 10 ml normal saline. Hemodynamic parameters like systolic blood pressure, diastolic blood pressure, heart rate (HR), mean arterial pressure (MAP), SpO₂ were monitored immediately, after intubation,1,3,5,10 minutes, at extubation and postoperatively.

Conclusion: In conclusion, Dexmedetomidine attenuates the hemodynamic stress response to direct laryngoscopy and endotracheal intubation more effectively compared to labetalol without any deleterious effects. Additionally, dexmedetomidine has good analgesic and sedation effects postoperatively.