Prevention of Pressor response to Laryngoscopy: A Comparison of Lignocaine with Dexmedetomidine

Abstract

Objective: To compare intravenous Lignocaine with Dexmedetomidine for prevention of pressor response to laryngoscopy. Study design and setting: Randomized Clinical Trial at Anesthesia Department, RIHS Islamabad. (1st May2019 To 30th October 2019) Methodology: 68 patients with age 20-60 years, ASA status(I or II), planned for elective surgeries under GA were included in this study and randomly divided into groups A and B by lottery method. Patients with history of hypertension, heart blocks, beta-blockers were excluded from study. Group-A patients were given injection Lignocaine 2% 1mg/kg 1min before induction and Group-B patients were given injection Dexmedetomidine 1ug/kg 15 min before induction of anesthesia. After premedication with injection Midazolam, Nalbuphine, and Ondansetron, Induction of anesthesia was done with injection Propofol and Cisatracurium. Patients were intubated. Use of stylet,BURP maneuver, incidence of laryngospasm was noted. Vitals before and after intubation were noted. Results: There was no significant difference in demographic profile,use of a stylet, BURP maneuver and laryngospasm in both groups. ANOVA test shows significant decrease in change in Systolic BP in Dexmedetomidine group at 2 and 3 minutes after intubation as compared to Lignocaine group however Diastolic BP and Heart rate was comparable in both groups. Paired t test showed a significant decrease in Systolic and Diastolic BP in both groups( more in Dexmedetomidine group).Regarding heart rate paired t test showed insignificant difference in Lignocaine group and significant difference in Dexmedetomidine group. Conclusion: Intravenous Dexmedetomidine is superior to Lignocaine to prevent pressor response to laryngoscopy.