Comparison of Nebulized Ropivacaine (0.75%) with Nebulized Dexmedetomidine on the Hemodynamic Response on Intubation in Patients Undergoing Surgery Under General Anesthesia: A Comparative Randomized Double-blind Placebo-controlled Study

Overview

Journal Saudi J Anaesth

Specialty Anesthesiology

Date 2024 Feb 5

PMID 38313724

Authors

Puja Saxena

Ravneet Kaur Gill

Richa Saroa

Bharti Sidhu

John Alen

Parul Sood

Affiliations

Soon will be listed here.

Abstract

Background: Laryngoscopy and tracheal intubation lead to sympathetic stimulation resulting in hemodynamic fluctuations. We compared local anesthetic ropivacaine 0.75% with alpha agonist dexmedetomidine through ultrasonic nebulization for direct local action of the drug in the airway.

Methods: In our randomized study, 180 patients were prospectively assigned to three groups of 60 each: group R (0.75%), group D (1 microgram/kg), and group C (control). The primary objective was to determine whether nebulized ropivacaine or nebulized dexmedetomidine can cause a reduction in stress response to laryngoscopy and intubation. The secondary objectives were to compare the hemodynamic parameters at extubation, cough response at extubation, and postoperative sore throat.

Results: A total of 165 patients were analyzed. Demographically, all the groups were similar. Group R and group D were found to significantly attenuate the heart rate (HR) at intubation and extubation when compared to group C ( < 0.05). A significant reduction in mean arterial pressure (MAP) was seen ( < 0.05; group D: 90 ± 18.4 mmHg, group C: 99.5 ± 15.9 mmHg, group R: 92.4 ± 16.1 mmHg). There was a significant reduction in cough response in both groups in comparison with group C at 0 minutes ( value group C vs group D: <.0001; group C vs group R:.01) and 5 minutes ( value group C vs group D: <.0001; group C vs group R: <.0001).

Conclusion: Preinduction topical use of ropivacaine or dexmedetomidine, through the nebulization route, effectively attenuated the pressor responses when compared to placebo.

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