Aim of our study was to compare efficacy of iv labetalol and iv dexmedetomidine in attenuating the hemodynamic response to laryngoscopy and intubation in patients undergoing elective surgery.
To compare the efficacy of iv labetalol and iv dexmedetomidine (two different doses).
To observe any adverse effects of these two drug in the specified dosage.
Pros :
Cons:
Dr. Nagat S El-Shmaa conducted study in 90 people comparing 0.25 mg/kg iv labetalol and 1mcg/kg dexmedetomidine for elective surgeries and studied about the haemodynamic changes, intubation responses were assessed and concluded that dexmedetomidine attenuates the haemodynamic stress response to laryngoscopy and intubation more effectively compared with labetalol without any side effects.
Dr. Singala conducted study of totally 160 patients comparing iv labetalol 0.3 mg/kg and 1 mcg/kg iv dexmedetomidine for laparoscopic elective surgeries concluded that iv dexmedetomidine more suitable than labetalol for maintaining normal haemodynamic parameters in patients predisposed to significant fluctuations in bp or heart rate, especially during period of stress. It also has a relatively lower incidence of side effects.
Michelle gulabani, Pavan Gurha and Nishi kulshreshtha conducted a comparative analysis of lignocaine 1.5 mg/kg and two different doses of iv dexmedetomidine (0.5 mcg/kg and 1 mcg/kg ), 90 adult patients aged 18-65 years of age, ASA 1 and 2 for elective surgeries. The study concluded that dexmedetomidine in a dose of 1mcg/kg effectively attenuates the haemodynamic response to laryngoscopy and endotracheal intubation. Dexmedetomidine 0.5 mcg/kg was effective in blunting tachycardic response to intubation but incompletely attenuated the increase in systolic and DBP. Lignocaine 1.5 mg/kg was more effective than dexmedetomidine 0.5 mcg/kg. finally dexmedetomidine 1mcg/ kg was proved to maintain haemodynamic stability associated with intubation and beneficial for cardiac patients where the stress response to laryngoscopy and intubation was highly desirable.
Dr. Mrunalini patel and team compared the effectiveness of dexmedetomidine versus iv labetalol in attenuation of haemodynamic stress responses of laryngoscopy and intubation and effect of post op sedation.. The study was conducted for 60 patients, posted foe elective surgeries under general anaesthesia taken. The parameters like HR, SBP, DBP, MAP, SPO2 and sedation score were monitored during before and after induction, intubation and 1,3,5 minutes. Concluded that there was a reduction in HR and MAP response to intubation in both dexmedetomidine and labetalol, but dexmedetomidine 1mcg/kg given iv slowly over 10 minutes attenuates the cardiovascular responses to laryngoscopy and intubation in a better manner than labetalol without any deleterious effect. There was statistically significant sedation properties in dexmedetomidine group.
Dr.B.Varalakshmy Anaesthesia DNB Resident 2nd Year Kauvery Hospital, Chennai
Dr. Murali Magesh Venugopal Consultant Anaesthesiologist Kauvery Hospital, Chennai