A COMPARATIVE STUDY BETWEEN INTRAVENOUS DEXMEDETOMIDINE AND 50% MAGNESIUM SULFATE IN ATTENUATION OF CARDIOVASCULAR RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION.

Abstract

INTRODUCTION: Hypertension and tachycardia subsequent to tracheal intubation have been well documented. In susceptible patients it can cause increase in perioperative morbidity and mortality. Many agents have been used to attenuate these undesirable hemodynamic responses to laryngoscopy and intubation with varying success.  Dexmedetomidine increases the hemodynamic stability by altering the stress induced sympatho-adrenal responses to laryngoscopy and intubation during surgery and emergence from anesthesia. On the other hand, magnesium sulfate can significantly attenuate the release of catecholamines at the time of laryngoscopy and tracheal intubation. AIM: The present study was aimed to compare Inj, Dexmedetomidine 1µg/kg and Magnesium sulfate 50mg/kg in attenuation of cardiovascular response to laryngoscopy and intubation. METHODS: A randomized prospective study was conducted in Silchar Medical College and Hospital, Silchar, Assam after obtaining Institutional Ethical Committee clearance and written informed consent from the patients. INCLUSION CRITERIA: Patients between age 18-60 years, of both sexes, ASA grade I&II and scheduled for elective surgical procedure under general anesthesia EXCLUSION CRITERIA: Refusal to informed consent, anticipated difficult airway, ASA grade III&IV, history of allergy to study drug, pregnant and lactating mother, any disorders of cardiovascular system, respiratory system, renal system, hepatic and neuromuscular conditions and duration of surgery less than 60mins. 100 patients were randomly allocated to two groups of 50 patients each. Group A received inj. dexmedetomidine (1.0μg / kg) and Group B received inj. Magnesium sulfate (50 mg/kg). Hemodynamic parameters of patients (HR, SBP, DBP, and MAP) were recorded immediately before anesthesia induction, just before intubation, just after intubation, at 2min, 5min and 10 minutes for the study purpose. All analyses were done by using two tailed test; p-value<0.05 was considered significant and <0.001 as highly significant. RESULTS: There was no significant difference between the groups with regard to demographic variables. The mean fall in HR, SBP, DBP and MAP values at 2 and 5 minutes of intubation were statistically highly significant (p=0.000) in group A as compared to group B. DISCUSSION: The results were compared with various other similar studies which had analyzed the effect of dexmedetomidine and magnesium sulfate for attenuation of cardiovascular response during laryngoscopy and intubation and our results correlated with those studies.