A Randomized Double Blind Controlled Study of Attenuation of Hemodynamic Responses to Laryngoscopy and Intubation after Intranasal and Intravenous Administration of Dexmedetomidine

Background and aims: Unfavorable hemodynamic responses following during laryngoscopy and intubation (L-I) are common. Preoperative intravenous (IV) Dexmedetomidine (DEX) has been shown to effectively reduce the laryngoscopic stress response. However, severe haemodynamic consequences such as hypotension, bradycardia, and even cardiac arrest may have limited IV DEX's use. Intranasal (IN) administration is more convenient and effective than other methods. The study's aim was to examine hemodynamic responses and other adverse effects between IV and IN DEX. Methods: This was a single centre randomised control study was conducted from Sep 2021 to Feb 2022 in the Department of Anaesthesia at GMC Kota. Individual patients underwent thorough pre-anaesthetic evaluations and investigations. Total 60 patients were separated into two equal groups and randomly assigned using a computer-generated random number table (Group -DIV and Group DIN). SPSS software version 16 was used for statistical analysis and ap valueless than 0.5 was considered to be statistically significant. Results: A total 60 patients were included. Demographic details and baseline parameters were not significantly different among both groups. There was no statistically significant difference(p-greater than0.05) were noted in pre-induction and post induction HR, SBP, DBP and MAP for all time interval till 40 min.When sedation was compared, it was found that maximum 18 (60%) patients in DIN group remained in RSS stage II and 22 (73.3%) patients in DIV group remained in RSS stage III at 40 min and this difference was found to be statistically significant (p-less than0.05). Conclusions: Our study concluded that both intravenous DEX (0.5 ?g/kg in 40 minutes) and intranasal DEX (1 ?g/kg) given 40 minutes before induction are equivalent efficacious in decreasing haemodynamic surges during laryngoscopy and intubation.