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Dexmedetomine Vs Esmol

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COMPARISON OF INTRAVENOUS DEXMEDETOMIDINE VERSUS ESMOLOL FOR ATTENUATION OF HEMODYNAMIC RESPONSE TO LARYNGOSCOPY AND ENDOTRACHEAL INTUBATION Abstract: Background: Esmolol has an established role in attenuation of hemodynamic response to laryngoscopy and endotracheal intubation. We studied the effect of Dexmedetomidine compared to that of esmolol in this study. Aim: To study the role of dexmedetomine in attenuation of hemodynamic response to laryngoscopy and oral endotracheal intubation compared to that of esmolol hydrochoride in patients posted for elective surgery under general anesthesia. Study Design: Prospective randomized study-double dummy blinding method Material and Methods: 60 ASA I patients, aged 18-60 years randomly divided into two groups; Group A patients received dexmedetomidine 1mcg/kg diluted in 50ml …show more content…

Dexmedetomidine has unique pharmacokinetics making it difficult to compare with other routinely used drugs like esmolol and lignocaine. We adopted a unique blinding technique-double dummy method to make this comparison between dexmedetomidine and esmolol possible in a ideal manner. We hypothesized that intravenous dexmedetomidine 1mcg/kg administered over 10mins prior to endotracheal intubation would attenuate the hemodynamic response to laryngoscopy and endotracheal intubation more effectively than intravenous esmolol 0.5mg/kg given as a bolus dose two minutes prior to intubation. This prospective, randomized, double blinded study was attempted to study and compare the effect of dexmedetomidine and esmolol in attenuation of hemodynamic response to oral endotracheal

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INTRODUCTION Spinal anesthesia is the most commonly used technique for lower abdominal and lower limb surgeries as it is very economical and easy to administerIntrathecal α2 agonist when used as adjunct potentiates the effect of local anaesthetics and allows a decrease in required doses.. Different drugs have been used as adjuvants to prolong the duration of intraoperative and postoperative analgesia adrenaline being the first drug used and latest being dexmedetomidine. These adjuvants have their own advantages and limitations. Efforts to find a better adjuvant are underway since long.

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The majority of patients receiving dexmedetomidine as a primary therapy experienced clinically effective sedation yet were still easily arousable, a unique feature not observed with other clinically available sedatives. Dexmedetomidine does not appear to have any direct effects on the heart . A biphasic cardiovascular response has been described after the application of dexmedetomidine. The administration of a bolus of 1 μg/kg dexmedetomidine initially results in a transient increase of the blood pressure and a reflex decrease in heart rate, especially in younger, healthy patients . The initial reaction can be explained by the peripheral α2B-adrenoceptor stimulation of vascular smooth muscle and can be attenuated by a slow infusion over 10 or more minutes.

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