V Jagadish,¹,Krishna chaitanya²Viditha

¹Assistant Professor, Department of Anaesthesia, ²Post graduate Student, Department of Anaesthesia, Narayana Medical College, Nellore, Andhra Pradesh, India.

Address for correspondenceDr. V. Jagadish, Assistant Professor, Department of Anaesthesia, Narayana Medical College, Nellore, Andhra Pradesh, India.

Email: vaddineni.jagadish@gmail.com

Background: : Dexmedetomidine(Dex), an α2 adrenoreceptor agonist, is widely used in various clinical settings for its sympatholytic, sedative, anaesthetic sparing and haemodynamic stabilizing properties without significant respiratory depression.

Objectives:The objective of this study is to evaluate the efficacy of dexmedetomidine in attenuating the sympathoadrenal response to tracheal intubation and reduction in requirements of propofol and fentanyl intra-operatively.

Materials and Methods : Hundred patients scheduled for elective surgeries like thyroidectomy and abdominal surgeries for more than 3 hours duration were randomly divided into group C and group D with 50 patients in each group. The control group received isoflurane–opioid and study group received isoflurane–opioid-dexmedetomidine anaesthesia. Dexmedetomidine infusion in a dose of 1 μg/kg was given over 10 min before the induction of anaesthesia and was continued at a dose of 0.2–0.7 μg/kg/hour until skin closure. All patients were induced with propofol, fentanyl and vecuronium. Haemodynamic variables were continuously recorded.

Results : : It was observed that dexmedetomidine effectively controlled the increase in heart rate following intubation compared to the control group 68.56 vs. 77.30 (p<0.0001). Reduction of mean arterial pressure was significant in dexmedetomidine group compared to control group(p< 0.0001). Dexmedetomidine reduced the intraoperative use of propofol compared to control group 92.04 (2.84) mg vs. 112.20 (7.90) (p<0.0001) and fentanyl compared to control group 81.5 (2.31) vs.105.40 (9.08) (p<0.0001). Dexmedetomidine also reduced postoperative analgesic requirement significantly compared to control group.

Conclusion:Perioperative infusion of dexmedetomidine is effective in attenuating sympathoadrenal response to tracheal intubation. It has significant anaesthetic and opioid sparing effect.

Keywords : Dexmedetomidine, Stress response, Analgesia, Tracheal intubation, Anaesthetic requirement