Abstract :
Introduction: Laryngoscopy and tracheal intubation is associated with profound adverse hemodynamic changes. Coronary artery disease patients have compromised myocardial blood flow and usually have associated hypertension. If the stress response to tracheal intubation is not controlled, it may lead to severe hypertension, arrhythmias and myocardial ischemia. Dexmedetomidine is a new alpha agonist with high potency to control the stress response, pain and tachyarrhythmia. Hence, impact of dexmedetomidine on hemodynamic parameters during tracheal intubation in coronary artery bypass grafting (CABG) surgery patients was evaluated in the study.
Methods: Sixty patients undergoing CABG were enrolled in the study. They were divided into 3 groups. Group 1 received thiopentone 3-5mg/kg, group 2 received thiopentone plus lignocaine 1mg/kg and group 3 received thiopentone plus dexmedetomidine 0.5µg/kg prior to laryngoscopy and tracheal intubation. Heart rate (HR), mean arterial pressure (MAP) and cardiac index (CI) were measured before induction, after anaesthetic induction, at laryngoscopy, and 1min, 3min, 6min and 10min after tracheal intubation. The extra amount of fentanyl and thiopentone required controlling hypertension to laryngoscopy and intubation was noted. The values were analyzed with SPSS 20 software with a P value of
Keyword :
Coronary artery bypass grafting surgery; dexmedetomidine; hemodynamic response; lignocaine; thiopentone; tracheal intubation