Attenuation of Hemodynamic Response to Tracheal Intubation with Pregabalin and Dexmedetomidine - A Prospective Randomized Double Blinded Study

Objective: Airway manipulation during endotracheal intubation is a potential stimulus and it isassociated with untoward hemodynamic changes. The aim of this study was to compare theefficacy of intravenous dexmedetomidine and oral pregabalin premedication for attenuation ofhemodynamic pressor response to laryngoscopy and intubation.Methods: A total of 60 patients of age group of 18-60 years scheduled for elective surgeriesunder general anesthesia with ASA physical status I were randomized into two groups. Group Dreceived intravenous dexmedetomidine at a dose of 1 µg kg-1 over 10 minutes before inductionand group P received oral pregabalin 150 mg one hour prior to intubation. The primary outcomes,heart rate and mean arterial pressure noted at serial intervals during intubation were comparedbetween the groups. Sedation score was assessed as secondary outcome using RichmondAgitation Sedation Scale Scores (RAAS).Results: Group D and P were comparable with distribution of age, sex and duration of laryngoscopy. The mean heart rates and mean arterial pressures assessed at serial measurements at 0, 1,3, 5, 10 minutes post- intubation were statistically significant (p=0.005) in dexmedetomidinegroup when compared to pregabalin group. The RASS scores assessed at 15, 30 and 60 minutespost-extubation were statistically significant (p

Trakeal Entübasyona Hemodinamik Yanıtın Pregabalin ve Deksmedetomidin ile AzaltılmasıProspektif Randomize Çift Kör Çalışma

Amaç: Endotrakeal entübasyon sırasında hava yolu manevrası potansiyel bir uyarıdır ve istenmeyen hemodinamik değişikliklerle ilişkilidir. Amaç, intravenöz deksmedetomidin ve oral pregabalin premedikasyonunun laringoskopi ve entübasyona hemodinamik cevabın azaltılmasındaki etkinliğini karşılaştırmaktı. Yöntem: 18-60 yaş arasında, ASA fiziksel durumu 1 olan, genel anestezi altında elektif cerrahi planlanan toplam 60 hasta randomize olarak iki gruba ayrıldı. D grubuna indüksiyondan önce 1 µg kg-1 intravenöz deksmedetomidin 10 dk.’da verildi ve P grubuna entübasyondan bir saat önce 150 mg oral pregabalin verildi. Primer sonuçlar, entübasyon sırasında seri aralıklarla kaydedilen kalp atım hızı ve ortalama arter basıncı gruplar arasında karşılaştırıldı. Sedasyon skoru, Richmond Ajitasyon Sedasyon Skoru (RAAS) kullanılarak sekonder sonuç olarak değerlendirildi. Bulgular: Grup D ve P, yaş, cinsiyet dağılımı ve laringoskopi süresi olarak benzerdi. Entübasyon sonrası 0, 1, 3, 5, 10 dk. gibi seri aralıklarla değerlendirilen ortalama kalp hızı ve ortalama arter basıncı, deksmedetomidin grubunda pregabalin grubuna göre istatistiksel olarak anlamlıydı (p=0.005). Ekstübasyondan 15, 30 ve 60 dk. sonra değerlendirilen RASS skorları, deksmedetomidin grubu ile karşılaştırıldığında pregabalin grubunda istatistiksel olarak anlamlıydı (p

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3. Sulaiman S, Karthekeyan R, Vakamudi M, Sundar A, Ravullapalli H, Gandham R. The effects of dexmedetomidine on attenuation of stress response to endotracheal intubation in patients undergoing elective offpump coronary artery bypass grafting. Ann Card Anaesth. 2012;15:39-43. https://doi.org/10.4103/0971-9784.91480

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7. Singh D, Yadav JS, Jamuda BK, Singh P. Oral pregabalin as premedication on anxiolysis and stress response to laryngoscopy and endotracheal intubation in patients undergoing laparoscopic cholecystectomy: A randomized double-blind study. Anesth Essays Res. 2019;13:97-104. https://doi.org/10.4103/aer.AER_12_19

8. Kakkar A, Tyagi A, Nabi N, Sethi AK, Verma UC. Comparision of clonidine and dexmedetomidine for attenuation of laryngoscopy and intubation response - A randomized controlled trial. J Clin Anesth. 2016;33:283-8. https://doi.org/10.1016/j.jclinane.2016.04.026

9. Waikar C, Singh J, Gupta D, Agrawal A. Comparative study of oral gabapentin, pregabalin, and clonidine as premedication for anxiolysis, sedation, and attenuation of pressor response to endotracheal intubation. Anesth Essays Res. 2017;11:558-60. https://doi.org/10.4103/aer.AER_34_17

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11. Vijayan NK, Talwar V, Dayal M. Comparative evaluation of the effects of pregabalin, dexmedetomidine, and their combination on the hemodynamic response and anesthetic aequirements in patients undergoing laparoscopic cholecystectomy: A randomized double-blind prospective Study. Anesth Essays Res. 2019;13:515-21. https://doi.org/10.4103/aer.AER_86_19

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Anestezi Dergisi-Cover
  • ISSN: 1300-0578
  • Yayın Aralığı: Yılda 4 Sayı
  • Başlangıç: 1993
  • Yayıncı: Betül Kartal
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