Abstract :
Introduction: Dexmedetomidine, a potent a2-adrenergic agonist with its sedative, anxiolytic, analgesic
and sympatholytic property ; is an ideal agent for premedication. The intravenous bolus is associated with
bradycardia and hypotension; hence we studied the intramuscular route for hemodynamic stability.
Materials and Methods: Sixty adult patients of ASA physical status I and II, aged between 18-60 years,
posted for ear surgery received intramuscular dexmedetomidine 2.5mg/kg 60 minutes prior to induction
of anesthesia as premedication in recovery room with either injection saline bolus in group D (n=30) or
intravenous fentanyl 1.5 mg/kg group DF (n=30) 2 mines before induction in operation theatre. Standard
induction technique was used. Sedation score and hemodynamic changes during laryngoscopy were
recorded.
Results: During laryngoscopy and intubation, transient rise in Heart Rate and Mean arterial pressure seen
in Group D as compared to Group DF; (p values within 3 minutes of laryngoscopy. No patient suffered from profound sedation at any point of observation.
Conclusion: This study provides evidence that intramuscular dexmedetomidine alone acts as
effective premedication agent with attenuation of stress response; and combination of Intramuscular
dexmedetomidine and intravenous fentanyl not only attenuate but also prevents stress response to
laryngoscopy and tracheal intubation.
Keyword :
Ear surgery, Tracheal intubation, Fentanyl, Laryngoscopy, Intramuscular dexmedetomidine.