Dexmedetomidine, an alpha-2 adrenergic agonist, has been shown to provide several benefits during endotracheal intubation:
1. \_Reduced anxiety and stress\_: Dexmedetomidine's anxiolytic and sedative effects help reduce anxiety and stress associated with endotracheal intubation. 2. \_Improved intubating conditions\_: Dexmedetomidine can improve intubating conditions by reducing the incidence of coughing, bucking, and laryngospasm. 3. \_Decreased hemodynamic responses\_: Dexmedetomidine can attenuate the hemodynamic responses to intubation, including tachycardia, hypertension, and increased cardiac output. 4. \_Increased ease of intubation\_: Dexmedetomidine can facilitate smoother and easier intubation by reducing the need for additional anesthetics or muscle relaxants.
The physiological responses to dexmedetomidine during intubation include:
1. \_Decreased heart rate\_: Dexmedetomidine can cause a decrease in heart rate due to its effects on the sympathetic nervous system. 2. \_Decreased blood pressure\_: Dexmedetomidine can also cause a decrease in blood pressure due to its vasodilatory effects. 3. \_Increased sedation\_: Dexmedetomidine's sedative effects can help reduce anxiety and stress during intubation. 4. \_Reduced respiratory rate\_: Dexmedetomidine can cause a decrease in respiratory rate due to its effects on the respiratory centers in the brain.
The clinical benefits of dexmedetomidine during intubation include:
1. \_Improved patient comfort\_: Dexmedetomidine's sedative and anxiolytic effects can improve patient comfort during intubation. 2. \_Reduced need for additional anesthetics\_: Dexmedetomidine can reduce the need for additional anesthetics or muscle relaxants during intubation. 3. \_Decreased risk of complications\_: Dexmedetomidine's effects on hemodynamic responses and respiratory rate can decrease the risk of complications during intubation.
ASA Grade II
Age > 60 years
Elective surgical procedures under GA.
All patients with a diagnosis of hypertension for 6 months or more and undergoing treatment with antihypertensive medications.
Patient refusal
ASA Grade III and IV
Severely Hypovolemic state
Emergency surgeries
Parallel
Dexmedetomidine Group / Group D
DrugIn this study, the intervention involve administrating 0.5 mcg/kg of Inj dexmedetomidine intravenously over 10 min to patients in intervention group/group D 2 minutes prior to Endotracheal intubation using laryngoscopy aiming to asses its efficacy in attenuating the pressor response to laryngoscopy.
Normal Saline (Placebo)
Other interventionThe Placebo group / group C will be administer Normal Saline without any active medication over 10 min to patients, 2 minutes prior to Endotracheal intubation using laryngoscopy to compare its effect to those of Dexmedetomidine in attenuating the pressor response to laryngoscopy.
Mean Arterial Pressure (MAP)
The primary outcome is to measure the change in Mean Arterial Pressure before endotracheal intubation and 5 minutes after intubation. An increase or decrease in MAP of 20 mmHg of patient's baseline MAP within 5 minutes of endotracheal intubation will be considered significant in our study. The focus is on whether Dexmedetomidine maintain MAP with 20mmhg of patient's baseline reading.
Heart Rate (HR)
A increase or decrease in HR of 20 bpm of patient's baseline HR within 5 minutes of endotracheal intubation will be considered significant in our study.
Blood pressure (BP)
An increase or decrease in BP of 20 mmHg of patient's baseline BP within 5 minutes of endotracheal intubation will be considered significant in our study.
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