Comparison of the Effectiveness of Preoperative Dexmedetomidine Nebulization versus Lignocaine Nebulization in Attenuation of Stress Response During Direct Laryngoscopy And Endotracheal Intubation in Elective Surgeries Under General Anaesthesia: A Randomised Control Study at a Tertiary Care Hospital, Mandya

Authors

Sumayya E., Mandya Institute of Medical Sciences, MandyaFollow
Kiran A V., Mandya Institute of Medical Sciences, MandyaFollow
Santhosh M C B., Mandya Institute of Medical Sciences, MandyaFollow
Shivakumar G, Mandya Institute of Medical Sciences, MandyaFollow

Author ORCID Identifier

https://orcid.org/0009-0006-7255-7977

Corresponding Author

Sumayya E.

Department of Anaesthesiology, MIMS, Mandya, Karnataka, India

sumayyasunie@gmail.com

Abstract

Introduction: Direct laryngoscopy and tracheal intubation are known to provoke harmful stimuli that can lead to transient, unpredictable, and variable hemodynamic alterations, primarily due to heightened sympathoadrenal activity.¹ Various pharmacological agents have been explored to mitigate this stress response; however, none have emerged as optimal.²

Aim: This study aims to compare the effects of nebulized dexmedetomidine in comparison to nebulized lignocaine on the hemodynamic stress response during direct laryngoscopy and tracheal intubation, including any adverse effects in patients undergoing general endotracheal anesthesia.

Materials and Methods: Informed consent was obtained from 60 patients aged 18 to 65 years, classified as ASA-PS I and II, who were scheduled for elective surgeries requiring general endotracheal intubation. The patients were randomly assigned to two groups: Group D received nebulized dexmedetomidine at a dosage of 1 mcg/kg, while Group L received nebulized 2% lignocaine at 1.5 mg/kg, both diluted to a total volume of 5 ml with normal saline, administered 10 minutes prior to induction. Hemodynamic responses (heart rate, systolic and diastolic blood pressures, mean arterial pressure, SpO2) were recorded and compared at baseline, post-nebulization, and post-intubation at intervals of 1, 3, 5, and 10 minutes. Sedation scores were assessed before and after nebulization until induction.

Results: The increase in heart rate during intubation and at subsequent time points was significantly lower in Group D compared to Group L. Additionally, the reduction in systolic blood pressure (SBP) and diastolic blood pressure (DBP) was more pronounced in patients from Group D. No significant differences were observed in SpO2 or sedation scores between the two groups. Both groups reported no significant adverse effects.

Conclusion: Both nebulized dexmedetomidine and lignocaine effectively reduced the stress response associated with laryngoscopy and intubation; however, dexmedetomidine demonstrated superior efficacy without adverse hemodynamic effects.

Publication Date

2025

Publisher

JSS Academy of Higher Education & Research

Conflict of Interest

nil

Keywords

Dexmedetomidine, lignocaine, nebulization, stress response

Word Count

2748

Recommended Citation

E. S, A V. K, M C B. S, G S. Comparison of the Effectiveness of Preoperative Dexmedetomidine Nebulization versus Lignocaine Nebulization in Attenuation of Stress Response During Direct Laryngoscopy And Endotracheal Intubation in Elective Surgeries Under General Anaesthesia: A Randomised Control Study at a Tertiary Care Hospital, Mandya. Digital Journal of Clinical Medicine. 2025; 7(2): -. doi: https://doi.org/10.55691/2582-3868.1228

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