Vol.:(0123456789) 1 3 European Archives of Oto-Rhino-Laryngology https://doi.org/10.1007/s00405-019-05521-6 LARYNGOLOGY Comparing the efect of dexmedetomidine and labetalol on hemodynamic variables in patients undergoing microlaryngoscopy Maryam Hatami 1  · Maryam Mashayekhi 1  · Hamidreza Abbasi 1  · Vida Ayatollahi 1  · Sedighe Vaziribozorg 2 Received: 20 May 2019 / Accepted: 14 June 2019 © Springer-Verlag GmbH Germany, part of Springer Nature 2019 Abstract Introduction This study was conducted to compare the efect of dexmedetomidine and labetalol on hemodynamic variables in patients undergoing microlaryngoscopy. Material and methods In this randomized clinical trial study 70 patients undergoing microlaryngoscopy were involved. The patients were randomly assigned into two groups. Patients in dexmedetomidine group received 0.5 μg/kg of dexmedetomidine diluted in 100 ml of saline solution and the patients in the second group received 0.25 mg/kg of labetalol before anesthesia induction. At the beginning of the surgery, dexmedetomidine was infused at the dose of 0.4 μg/kg/h in the dexmedetomidine group, and labetalol at the dose of 1.8 mg/kg/h in the labetalol group. Patients’ systolic blood pressure, diastolic blood pres- sure, mean arterial blood pressure and heart rate at diferent times and anesthesia and surgery duration, recovery time and dose of prescribed propofol were recorded and compared between two groups. Results There was a signifcant diference in mean systolic blood pressure, mean diastolic blood pressure, mean arterial blood pressure and mean heart rate between two groups at diferent times (p value < 0.05). Conclusion The results of this study indicated that dexmedetomidine had higher efcacy, compared to labetalol, in reducing diastolic blood pressure, systolic blood pressure, heart rate, and mean arterial blood pressure following microlaryngoscopy. Keywords Microlaryngoscopy · Dexmedetomidine · Labetalol · Hemodynamic variables Introduction Laryngoscopy is one of the most painful stimuli during anes- thesia and surgery. Laryngoscopy and tracheal intubation are associated with hemodynamic changes such as hypertension, tachycardia, dysrhythmia and myocardial ischemia, intracer- ebral hemorrhage, and increased intraocular pressure along with increased circulation of catecholamines. The laryngo- scope is located in the patient’s mouth for a longer time in microlaryngoscopy than in laryngoscopy for tracheal intu- bation. As a result, this intense and prolonged stimulation caused by microlaryngoscopy can greatly afect the patient’s hemodynamic parameters [1]. To decrease the severity of laryngoscopy-induced stimulation during tracheal intuba- tion, various practices have been investigated and applied such as increase of anesthesia depth, administration of intravenous lidocaine, administration of adequate opioids, the use of items such as vasodilators, namely nitroglycerin, clonidine, beta-blocker, calcium-blocker, etc. Dexmedeto- midine is known as a highly selective α2 adrenoceptor ago- nist [2]. Dexmedetomidine, as an adjuvant during general anesthesia, contributes to the patient’s hemodynamic stabil- ity through its central sympathetic efect; in addition, it has a powerful sedative and analgesic efect [3–5], decreasing the need for opioids administration and consequently their complications, reducing the stress response, and improving the quality of recovery [6, 7]. Labetalol is a medication used to treat hypertension, and it is a combination of alpha–beta- adrenergic antagonists [8]. The main physiological action of labetalol is to compete for blocking adrenergic stimulation of β-receptors within the myocardium and vascular smooth muscle, decreasing the pressure of systemic arterial and the resistance of the systemic vascular without a notable reduc- tion in resting heart rate, cardiac output, or stroke volume. * Sedighe Vaziribozorg s.vaziribozorg1408@gmail.com 1 Departments of Anesthesiology, Shahid Sadoughi University of Medical Sciences, Yazd, Iran 2 Department of Otolaryngology-Head and Neck Surgery, Otorhinolaryngology Research Center, Shahid Sadoughi University of Medical Sciences, Yazd, Iran