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American Journal of Drug Discovery and Development
Year: 2017  |  Volume: 7  |  Issue: 1  |  Page No.: 39 - 47

Comparison Between the Effect of the Intravenous Dexmedetomidine with Fentanyl on the Propofol Induction Dose Requirement and the Hemodynamic Response Due to Laryngoscopy and Tracheal Intubation

Syafri Kamsul Arif, Imtihanah Amri and Anwar Mallongi    

Abstract: Background: Laryngoscopy and endotracheal intubation can cause increase in sympathetic activity and simpatoadrenal reflex, associated with increased blood pressure and heart rate. The objective of this study was to compare the effects of dexmedetomidine 0.75 μg kg–1 b.wt., and fentanyl 2 μg kg–1 b.wt., to propofol induction dose requirement and hemodynamic response due to laryngoscopy and endotrakheal intubation. Materials and Methods: Randomized, single-blind controlled study, involving 48 patients with ASA physical status I and II planned for elective surgery with general anesthesia in DR (Wahidin Sudirohusodo hospital). Subjects are divided into two groups and each group is given dexmedetomidine (D) 0.75 μg kg–1 b.wt. or fentanyl (F) 2 μg kg–1 b.wt. intravenously before induction of propofol (50 mg kg–1 h–1) until the BIS reached 48±2, continued administration of atracurium 0.5 mg kg–1 and maintenance with 1.0 vol% isoflurane in oxygen 60%. Systolic and diastolic blood pressure, mean arterial pressure and heart rate are recorded at 1, 3 and 5 min after intubation as well as side effects. Results: Induction dose requirement in D group was less than the F group (p<0.05). In the 1st min, there is a 16.32% increase in average MAP and 18.88% in mean heart rate in F group, whereas a 2.90% increase in average MAP and 3.37% decrease of average heart rate was observed in D group. In the 3rd and 5th min, both groups were able to prevent increase in blood pressure but the F group has not been able to prevent an increase in average heart rate at the 3rd min (3.99% increase). The incidence of hypertension and tachycardia were significantly different (p<0.05) between the two groups. Conclusion: Induction dose requirement in dexmedetomidine group is less than the fentanyl group (p<0.05). Hemodynamic response on dexmedetomidine 0.75 μg kg–1 b.wt., is more stable than fentanyl 2 μg kg–1 b.wt., at 1st min after intubation but at 3rd and 5th min after intubation both groups can maintain stable hemodynamic response with a lower mean heart rate achieved by dexmedetomidine.

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