Intravenous Dexmedetomidine versus intranasal dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and tracheal intubation: A double blinded RCT from Maharashtra

Abstract

Introduction: Dexmedetomidine can be given by various route like intravenous, intramuscular, oral, intranasal. It is established that preoperative use of intravenous Dexmedetomidine can successfully attenuate the laryngoscopic stress response. However, adverse haemodynamic complications like hypotension, bradycardia and even cardiac arrest might have hindered the widespread use of intravenous Dexmedetomidine. Objective: To compare pulse rate (PR), mean arterial pressure (MAP), systolic blood pressure (SBP) and diastolic blood pressure (DBP), SpO2 between two groups in pre intubation and post intubation period Methodology: The present double blinded RCT carried out in patients that were randomly allocated using computer generated randomization list into 2 groups with 30 patients in each group with allocation ratio 1:1. Group IV DEX: intravenous Dexmedetomidine. Group IN DEX: intranasal Dexmedetomidine. Results: Mean age of Group IN DEX was 42.27 ± 11.63 years. There were 12 and 14 males were included in Group IV DEX and Group IN DEX.  There were 18 and 16 males were included in Group IV DEX and Group IN DEX.  There was no statistically significant difference in SBP, DBP, MAP, Spo2 at all time interval in both group (p>0.05). There was no statistically significant difference in SBP, DBP, MAP, SPO2 at time of intubation (p>0.05). There was no statistically significant difference in SBP, DBP, MAP, Spo2 at all time interval in both groups (p>0.05). Conclusion: Intranasal Dexmedetomidine is as effective as intravenous Dexmedetomidine for attenuation of haemodynamic response to laryngoscopy and tracheal intubation

Key words: Intravenous Dexmedetomidine versus intranasal dexmedetomidine, laryngoscopy and tracheal intubation