Jebmh.com Original Article J. Evid. Based Med. Healthc., pISSN- 2349-2562, eISSN- 2349-2570/ Vol. 3/Issue 33/Apr. 25, 2016 Page 1543 COMPARATIVE STUDY OF ATTENUATION OF CARDIOVASCULAR RESPONSE TO LARYNGOSCOPY AND INTUBATION WITH IV DEXMEDETOMIDINE VS. IV LIGNOCAINE P. V. Shiva 1 , M. Pavani 2 , B. Deepraj Singh 3 1 Associate Professor, Department of Anaesthesiology, Government Medical College, Nizamabad, Telangana. 2 Consultant Anaesthesiologist, Department of Anaesthesiology, Secunderabad Hospital, Secunderabad, Telangana. 3 Professor, Department of Anaesthesiology, Osmania Medical College, Hyderabad, Telangana. ABSTRACT Endotracheal intubation is one of the most commonly performed procedures, where the role of the anaesthesiologists in patient care is noteworthy. Endotracheal intubation is translaryngeal placement of endotracheal tube into the trachea via the nose or mouth. General anaesthesia procedures involve stressful events at various stages. The most stressful situations are seen during the period of induction, intubation and extubation. A 25% to 50% increase in mean arterial pressure and heart rate is seen during induction followed by laryngoscopy and intubation peaking at 1-2 minutes and returning to baseline within 10-15 minutes. AIMS AND OBJECTIVES A comparative study of attenuation of cardiovascular response to laryngoscopy and intubation with IV dexmedetomidine vs IV lignocaine, to compare changes in HR, systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial pressure (MAP) in patients premedicated with dexmedetomidine and lidocaine and to observe for any significant difference in the anaesthetic requirement and intraoperative complications if any in both the groups. METHODOLOGY A total of 60 patients undergoing elective surgeries were selected. Group D consists of 30 patients, who received IV dexmedetomidine loading dose, 1 mcg/kg diluted in 50 mL NS for 10 minutes prior to laryngoscopy. Group –L consists of 30 patients who received plain preservative-free Lidocaine 2%, 1.5 mg/kg body weight IV bolus ninety seconds prior to laryngoscopy. RESULTS Dexmedetomidine in a bolus dose of 1 ug/kg IV attenuates heart rate response to laryngoscopy and intubation effectively than plain preservative-free lignocaine. The basal values of heart rate were reached within 1 min after intubation in case of dexmedetomidine group. Dexmedetomidine blunts the increase in systolic, diastolic and mean arterial pressure effectively than Plain preservative-free Lignocaine. KEYWORDS Inj. Dexmedetomidine, Inj. Lignocaine. HOW TO CITE THIS ARTICLE: Shiva PV, Pavani M, Singh DB. Comparative study of attenuation of cardiovascular response to laryngoscopy and intubation with IV dexmedetomidine vs. IV lignocaine. J. Evid. Based Med. Healthc. 2016; 3(33), 1543-1550. DOI: 10.18410/jebmh/2016/348 INTRODUCTION: Since 1950s hypertension and tachycardia have been recognised as commonly associated with intubation under light anaesthesia. 1 The mechanical stimulation of four areas of upper respiratory tract - the nose, the epipharynx, the laryngopharynx and tracheobronchial tree induces reflex cardiovascular response which is associated with enhanced neuronal activity in cervical sympathetic fibres. This response is accompanied by raised plasma adrenaline concentration. These changes are probably of little consequence in healthy patients. But this cardiovascular response to intubation is of a serious concern in patients with hypertension, raised intracranial pressure, diseased cerebral vasculature or with ischaemic heart disease where increase in myocardial oxygen consumption can lead to myocardial infarction. 2 Failure to blunt the responses to intubation may have disastrous consequences like acute left ventricular failure, intracranial haemorrhage and pulmonary oedema. Convulsions may be precipitated in eclamptic patients. Herniation of intracranial contents and cerebral ischaemia can occur in patients with raised intracranial pressure. Arrhythmias (sinus tachycardia and sinus bradycardia, atrial and ventricular extra systoles and pulsus alternans, less commonly multifocal extra systoles, pulsus bigeminy and atrial fibrillation) are reported. Heart block, ventricular tachycardia and ventricular fibrillation are fortunately rare. Different techniques with different drugs have been suggested to attenuate these responses. The stress response can also be minimised by decreasing the duration of laryngoscopy to less than 15 seconds. Some Financial or Other, Competing Interest: None. Submission 21-03-2016, Peer Review 04-04-2016, Acceptance 12-04-2016, Published 25-04-2016. Corresponding Author: Dr. B. Deepraj Singh, #1-7-145/15, Musheerabad-500020, Hyderabad, Telangana. E-mail: drdeepraj@gmail.com DOI: 10.18410/jebmh/2016/348