Evaluation of the role of Dexmedetomidine premedication on rate pressue product following tracheal intubation
Objectives: Laryngoscopy and tracheal intubation produce sympathetic over drive by catecholamine release resulting in hypertension and tachycardia. This is usually tolerated by healthy individuals but susceptible patients are
likely to succumb to the hemodynamic fluctuations. Various agents are being tried to combat the intubation response over the years. This
study is aimed at evaluating the efficacy of Dexmedetomidine which is a highly selective alpha2 agonist in attenuating the hemodynamic
response to laryngoscopy and tracheal intubation.
Methodology: 60 patients scheduled for general anesthesia were divided into two groups, D and C with 30 patients in each group. Hypertension, diabetes mellitus, thyroid disease, treatment with beta blockers and difficult airway constituted the exclusion criteria. Group-D patients received Dexmedetomidine 0.5mcg/kg and group-C patients received normal saline[placebo] as intravenous premedication over 5min
before a rapid sequence induction and tracheal intubation. Blood pressure and heart rate were measured using invasive arterial line and
rate pressure product[RPP] was calculated at various time points including baseline, before induction, before intubation, at every 5sec after
intubation up to 1min and at 5, 10 and 15min. Mean RPPs were compared between the groups at the said time points.
Results: Mean RPP in Dexmedetomidine group was significantly less than in control group at almost all the time points of measurement.
Conclusion: Dexmedetomidine is effective in attenuating the hemodynamic response to laryngoscopy and tracheal intubation.