Origi na l A r tic le DOI: 10.

17354/ijss/2015/575

Lignocaine and Dexmedetomidine in Attenuation of

Pressor Response to Laryngoscopy and Intubation:
A Prospective Study
H K Sale1, Vitthal J Shendage2
Professor & Head, Department of Anaesthesiology, Noble Hospitals, Pune, Maharashtra, India, 2Consultant, Department of Anaesthesiology,
1

Noble Hospitals, Pune, Maharashtra, India

Abstract
Background: Dexmedetomidine is a α2 agonist with sedative, sympatholytic, and analgesic properties and hence, it can be
a very useful adjuvant in anesthesia as stress response buster, sedative, and analgesic. We aimed primarily to evaluate the
effects of dexmedetomidine on hemodynamic response to critical incidences such as laryngoscopy and endotracheal intubation.
Materials and Methods: In this randomized, comparative, prospective study total 60 patients of either sex, of American Society
of Anesthesiologists (ASA) Grades I or Grade II, aged between 20 and 60 years undergoing elective surgical procedures with
written and informed consent were selected for the study. 60 patients randomly assigned to one of the two groups of 30 each.
Group L received intravenous lignocaine while Group D received intravenous dexmedetomidine. 60 patients of ASA physical
Grades I and II undergoing laryngoscopy and endotracheal intubation were randomly allocated into two groups of 30 patients
each. Group D patients received intravenous dexmedetomidine (1 mcg/kg) before laryngoscopy and intubation (infusion over
10 min with 50 ml syringe and infusion pump diluted in normal saline), and Group L received intravenous lignocaine (1.5 mg/kg)
3 min before laryngoscopy and intubation. Parameters noted were heart rate (HR), systolic blood pressure (SBP), diastolic
blood pressure (DBP), and mean arterial pressure (MAP). Statistical Package for Social Sciences 19.0 version software was
used for statistical analysis.
Results: In Group L, significant hemodynamic stress response was seen following laryngoscopy and tracheal intubation. In
dexmedetomidine group, the hemodynamic response was significantly attenuated. The results, however, were statistically better
after 5 min of laryngoscopy and tracheal intubation than at 1 min. No significant side effects were noted other than bradycardia
in a single patient of Group D.
Conclusion: Efficacy of dexmedetomidine (1 mcg/kg) in attenuation of the pressor response to laryngoscopy and intubation
compared to lignocaine (1.5 mg/kg) is significantly higher in ASA-I and II patients with respect to HR, SBP, DBP, and MAP.

Key words: Dexmedetomidine, Endotracheal intubation, Hemodynamic stress response, Laryngoscopy

INTRODUCTION Laryngoscopy results in stimulation of larynx, pharynx,

epipharynx, and trachea, which are extensively innervated
Laryngoscopy and endotracheal intubation are part of by the autonomic nervous system, activation of which
the induction of general anesthesia. The occurrence leading to various cardiovascular changes such as increase
of hemodynamic responses during laryngoscopy heart rate (HR), systolic blood pressure (SBP), diastolic
and endotracheal intubation is a well-known hazard.1 blood pressure (DBP), mean arterial pressure (MAP),
dysrhythmias, cardiac asystole, and even sudden death.2-6
Access this article online These changes may prove to be detrimental especially
in patients with ischemic heart disease, cerebrovascular
Month of Submission : 10-2015 disease, hypertension, old age, and diabetes mellitus.
Month of Peer Review : 11-2015 Several techniques have been studied to attenuate
Month of Acceptance : 12-2015 this stress response, but none of them are completely
Month of Publishing : 12-2015 satisfactory. Hence, there is a constant search to attenuate
[Link]
the hemodynamic response to laryngoscopy and
Corresponding Author: Dr. Vitthal J Shendage, Department of Anaesthesiology, Noble Hospitals, 153, Magarpatta City Road,
Pune - 411 013, Maharashtra, India. E-mail: shendagevj@[Link]

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 Sale and Shendage: Comparative Study of Lignocaine and Dexmedetomidine in Attenuation of Pressor Response to
Laryngoscopy and Intubation

endotracheal intubation. Modern anesthesia practices, pump was set so as to deliver the targeted infusion rate.
therefore, plan to prevent sympathetic discharge and After taking the patient on the operation table, a multipara
provide hemodynamic stability perioperatively. Various monitor was attached, and the baseline HR, SBP, DBP, and
agents in the form of opioid analgesics, benzodiazepines, MAP were noted down. A wide bore intravenous cannula
beta blockers, calcium channel blockers, and vasodilators was inserted for giving the intravenous fluids, and another
have been used to achieve this objective with variable line was taken up for the infusion pump. Premedication
success. In last few years, a great enthusiasm has been was administered to all with 2 mcg/kg fentanyl, 0.03 mg/kg
shown toward the use of α2 agonists in anesthesia practice midazolam, and 5 mcg/kg glycopyrrolate 15 min before
because of their anxiolytic, sedative, sympatholytic, and induction of general anesthesia by an intravenous
analgesic-sparing properties.7 route. At the time of induction, all the patients received
injection ranitidine 50 mg and injection ondansetron
Dexmedetomidine, introduced in 1999 for human use, 4 mg by the intravenous route. All patient were received
is a selective α2 agonist with 8 times more affinity for α2 either intravenous lignocaine (1.5 mg/kg) 3 min before
adrenergic receptors compared to clonidine and possesses laryngoscopy and intubation and Group D were received
all the properties of α2 agonist without respiratory intravenous dexmedetomidine (1 mcg/kg) before
depression.8,9 Intravenous use of dexmedetomidine in laryngoscopy and intubation (infusion over 10 min with
the perioperative period had been found to decrease 50 ml syringe and infusion pump diluted in normal saline).
serum catecholamine levels by 90%, 10 to blunt the Patients were pre-oxygenated with 100% oxygen for
hemodynamic response to laryngoscopy, tracheal 3 min. Anesthesia was induced with 6 mg/kg thiopentone
intubation, pneumoperitoneum, and extubation, 11 to sodium and 0.1 mg/kg vecuronium. Laryngoscopy
provide sedation without respiratory depression and to using Macintosh blade size 3 and intubation using the
decrease post‑operative analgesic requirements.12 intratracheal tube (size 7.5-8 mm/cuffed) were carried out
by a senior anesthesiologist or by a 2-year trained resident
The primary aim of this study was, therefore, to evaluate in anesthesiology. HR, SBP, DBP, and MAP were recorded
the effects of dexmedetomidine on hemodynamic response before injection of study drug (baseline), after induction of
to critical incidences such ass laryngoscopy, endotracheal anesthesia (before laryngoscopy) and 1, 3, and 5 min after
intubation, and compare with lignocaine. intubation. Anesthesia maintained with O2:N2O (40:60),
isoflurane mixture, and vecuronium. Manipulations, such
MATERIALS AND METHODS as painting and draping the area, were not allowed till 5 min
after intubation. At the end of the surgery, reversal was
The present study was carried out from June 2010 to June done with neostigmine 0.05 mg/kg and glycopyrrolate
2011, after taking the permission and approval from the 10 mcg/kg. Extubation was done after adequate reversal
Departmental Ethical Committee and the written informed of the non-depolarizing muscle relaxant. An observation
consent from the patients. It was a prospective, randomized, made related to adverse effects of drugs and anesthesia-
comparative, clinical study. 60 American Society of related problems and attended appropriately. Findings
Anesthesiologists (ASA) physical status Grades I and II noted as per tables for further statistical analysis. The data
patients between 20 and 60 years, of either sex and posted obtained from the study were organized and analyzed by
for surgeries under general anesthesia with laryngoscopy applying appropriate statistical tests. To test the statistical
and intubation, were included in the study. Patients with significance of the difference of categorical variables
decreased autonomic control such as the elderly, diabetic across two study groups (Group D vs. Group L), we used
patients, patients with chronic hypertension, or severe Statistical Package for Social Sciences 19.0. The statistically
cardiac disease; patients on drugs such as β blockers or significant difference of average clinical parameters (such
calcium channel blockers, pregnant, or lactating women; as HR, SBP, DBP, and MAP) between two study groups
patients with a history of allergy to egg proteins and has been tested using independent sample t-test after
drugs particularly α2 agonists were not considered for the confirming the underlying normality and equal variance
study. The patients were randomly allocated by envelope assumptions. The P < 0.05 was considered statistically
method into two groups of 30 patients each, Group D significant. All the hypotheses were formulated using two-
received intravenous dexmedetomidine (1mcg/kg) before tailed alternatives against each null hypothesis.
laryngoscopy and intubation (infusion over 10 min with
50 ml syringe and infusion pump diluted in normal saline) RESULTS
and Group L received intravenous lignocaine (1.5 mg/kg)
3 min before laryngoscopy and intubation for attenuation Both the groups under study were comparable to each other
of stress response. Infusion was prepared according to the with respect to gender, ASA grading, age, weight, height,
Group D on the basis of the weight of the patient; the duration of surgery, and anesthesia (Tables 1-5).

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 Sale and Shendage: Comparative Study of Lignocaine and Dexmedetomidine in Attenuation of Pressor Response to
Laryngoscopy and Intubation

Table 1: Gender wise distribution of patients in Table 6: Comparison of distribution of

Group D and Group L hemodynamic changes in terms of relative
Gender Group P value percentages in clinical parameters studied
Group D Group L
between Group L and Group D
Male 18 18 0.99 % Change B BL 1 min 3 min 5 min
Female 12 12 HR (%)
Total 30 30 Group L 0.0 3.63 9.36 11.23 5.93
Group D 0.0 −9.46 −8.13 −6.6 −11.46
SBP (%)
Group L 0.0 −1.2 5 4.56 0.3
Table 2: Distribution of patients with respect to Group D 0.0 −21.28 −12.8 −18.47 −25.17
ASA grade in Group D and Group L DBP (%)
Group L 0.0 1.6 7.06 6.76 0.5
ASA Group P value
Group D 0.0 −10.5 −9.73 −11.5 −20.73
grade Group D Group L Mean BP (%)
I 22 22 0.99 Group L 0.0 0.67 6.4 6.1 0.47
II 8 8 Group D 0.0 −13.4 −10.5 −13.53 −22.2
Total 30 30 Values are Mean (SD). % Change is calculated with respect to baseline values.
DBP: Diastolic blood pressure, BP: Blood pressure, SBP: Systolic blood pressure,
ASA: American Society of Anesthesiologists
HR: Heart rate

Table 3: Comparison of age (years) in Group D and 8). 1 min after laryngoscopy and intubation the MAP was
Group L increased by 6.4% of baseline value. At the end of 3 min, the
Group Number of patients Age (years) (mean±SD) P value
MAP was 6.1% above baseline. At the end of 5 min, MAP was
Group D 30 39.50±11.56 0.857
0.47% which was comparable to the baseline value (Table 9).
Group L 30 40.03±11.22
SD: Standard deviation Group D (dexmedetomidine group)
In Group D after thiopentone sodium induction, there
was decrease in HR by 9.46% (compared to increase by
Table 4: Comparison of weight (kg) in Group D and 3.63% in Group L), fall in SBP by 21.28% (compared to
Group L decrease by 1.14% in Group L), and decrease in MAP by
Group Number of patients Weight (mean±SD) P value 13.4% of baseline value (compared to increase by 0.67% in
Group D 30 61.33±12.25 0.687 Group L) (P < 0.001) (Table 6). 1 min after laryngoscopy
Group L 30 60.03±16.64 and intubation the HR was lower than baseline by 8.13%
SD: Standard deviation
(compared to increase by 9.86% in Group L). At the end of
3 min, the HR remained lower by 6.6% over baseline value
Table 5: Comparison of height (cm) in Group D and (compared to increase by 11.23% in Group L). At the end of
Group L 5 min, HR was still on lower side by 11.46% (compared to
Group Number of patients Height (mean±SD) P value
increase by 5.93% in Group L) of baseline value (P < 0.001)
Group D 30 159.67±12.32 0.198
(Table 6). 1 min after laryngoscopy and intubation, the
Group L 30 155.07±14.91 SBP was lower by 12.8% of baseline value (compared to
SD: Standard deviation increase by 5.93% in Group L). At the end of 3 min, the SBP
remained low by 18.8% of baseline (compared to increase
Comparison between Group L and Group D by 4.56% in Group L). At the end of 5 min, SBP was still
Group L (lignocaine group) lower by 25.47% of baseline value (compared to increase
In Group L after thiopentone sodium induction, there was by 0.3% in Group L) (P < 0.001) (Table 6). 1 min after
increase in HR by 3.63%, fall in SBP by 1.2% and increase laryngoscopy and intubation, the MAP was lower 10.5% of
in MAP by 0.67% of baseline value (Table 6). 1 min after baseline value (compared to increase by 6.4% in Group L).
laryngoscopy and intubation, the HR was further increased At the end of 3 min, the MAP remained low by 13.53% of
by 9.36% of baseline value. At the end of 3 min, the HR baseline (compared to increase by 6.1% in Group L). At the
remained 11.23% above baseline. At the end of 5 min, end of 5 min, MAP was 22.2% of baseline value (compared
HR was 5.93% which was still higher than baseline value to increase by 0.47% in Group L) (P < 0.001) (Table 6).
(Table 7). 1 min after laryngoscopy and intubation the SBP
was increased by 5% of baseline value. At the end of 3 min, Using two independent sample proportion test P > 0.05,
the SBP was 4.56% above baseline. At the end of 5 min, SBP therefore, there is no significant difference between the
was 0.3% which was comparable to the baseline value (Table proportion of gender in Group D and Group L (Table 1).

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 Sale and Shendage: Comparative Study of Lignocaine and Dexmedetomidine in Attenuation of Pressor Response to
Laryngoscopy and Intubation

Table 7: Comparison of pulse rate at baseline, before laryngoscopy, 1st min after laryngoscopy, 3rd min
after laryngoscopy, and 5th min after laryngoscopy in Group D and Group L
Pulse rate Number of Group P value
patients Group D Group L
Baseline 30 78.13±13.73 76.97±10.89 0.717
Before laryngoscopy 30 68.67±11.70 80.60±6.58 <0.001
1st min after laryngoscopy 30 70.00±11.77 86.83±6.13 <0.001
3rd min after laryngoscopy 30 71.53±11.22 88.20±4.51 <0.001
5th min after laryngoscopy 30 66.67±8.54 82.90±4.64 <0.001

Table 8: Comparison of SBP at baseline, before laryngoscopy, 1st min after laryngoscopy, 3rd min after
laryngoscopy, and 5th min after laryngoscopy in Group D and Group L
SBP Number of Group P value
patients Group D Group L
Baseline 30 121.80±10.55 122.47±8.01 0.784
Before laryngoscopy 30 100.52±7.94 121.27±7.73 <0.001
1st min after laryngoscopy 30 109.00±8.98 127.47±8.69 <0.001
3rd min after laryngoscopy 30 103.33±8.21 127.03±7.30 <0.001
5th min after laryngoscopy 30 96.63±8.84 122.77±6.13 <0.001
SBP: Systolic blood pressure

Table 9: Comparison of MAP at baseline, before laryngoscopy, 1st min after laryngoscopy, 3rd min after
laryngoscopy, and 5th min after laryngoscopy in Group D and Group L
MBP Number of Group P value
patients Group D Group L
Baseline 30 91.00±7.80 90.23±6.44 0.680
Before laryngoscopy 30 77.60±6.87 90.90±5.73 <0.001
1st min after laryngoscopy 30 80.50±7.09 96.63±6.66 <0.001
3rd min after laryngoscopy 30 77.47±7.49 96.33±6.89 <0.001
5th min after laryngoscopy 30 68.80±8.19 90.70±5.33 <0.001
MAP: Mean arterial pressure, BP: Blood pressure

Using independent sample proportion test P > 0.05, 1st, 3rd, and 5th min after laryngoscopy in Group D and
therefore, there is no significant difference between Group L (Table 7).
proportions of ASA grade in Group D and Group L
(Table 2). Using two independent sample t-test P > 0.05, therefore,
there is no significant difference between mean SBP at
Using two independent sample t-test P > 0.05, therefore, baseline. P < 0.05, therefore, there is a significant difference
there is no significant difference between mean age (years) between mean SBP at before laryngoscopy, 1st, 3rd, and
Group D and Group L (Table 3). 5th min after laryngoscopy in Group D and Group L
(Table 8).
Using two independent sample t-test P > 0.05, therefore,
Using two independent sample t-test P > 0.05, therefore,
there is no significant difference between mean weights
there is no significant difference between mean DBP at
(kg) Group D and Group L (Table 4).
baseline. P < 0.05, therefore, there is a significant difference
between mean DBP at before laryngoscopy, 1st, 3rd, and
Using two independent sample t-test P > 0.05, therefore,
5th min after laryngoscopy in Group D and Group L
there is no significant difference between mean heights (Table 10).
(kg) Group D and Group L (Table 5).
Using two independent sample t-test P > 0.05, therefore, there
Using two independent sample t-test P > 0.05, therefore, is no significant difference between mean MAP at baseline.
there is no significant difference between mean pulse P < 0.05, therefore, there is a significant difference between
rates at baseline. P < 0.05, therefore, there is a significant mean MAP at before laryngoscopy, 1st, 3rd, and 5th min after
difference between mean pulse rates at before laryngoscopy, laryngoscopy in Group D and Group L (Table 9).

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 Sale and Shendage: Comparative Study of Lignocaine and Dexmedetomidine in Attenuation of Pressor Response to
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Table 10: Comparison of DBP at baseline, before laryngoscopy, 1st min after laryngoscopy, 3rd min after
laryngoscopy, and 5th min after laryngoscopy in Group D and Group L
DBP Number of Group P value
patients Group D Group‑L
Baseline 30 76.20±7.13 74.67±6.42 0.385
Before laryngoscopy 30 65.70±6.68 76.27±5.25 <0.001
1st min after laryngoscopy 30 66.47±6.80 81.73±6.20 <0.001
3rd min after laryngoscopy 30 64.70±7.36 81.43±6.65 <0.001
5th min after laryngoscopy 30 55.47±8.88 75.17±5.36 <0.001
DBP: Diastolic blood pressure

DISCUSSION analgesia. Sedation produced by α2 agonists is unique

in the sense that the patients can be easily aroused to
Dexmedetomidine is a highly selective α2 adrenergic co‑operate during procedures and also respond to the
agonist. It acts through three types of α2 receptors‑α2 verbal commands and then can return to sleep like state
A, α2 B, and α2 C situated in the brain and spinal cord. when not stimulated.16 Keniya et al.,18 who also shown that
The resultant action is sedation, anxiolysis, analgesia, 1 mcg/kg dexmedetomidine effectively attenuated pressor
and sympatholysis, the latter leading to hypotension and response to laryngoscopy and subsequent intubation, where
bradycardia. Activation of α2 A receptors in the brain stem dexmedetomidine group was compared to the control
vasomotor center results in suppression of norepinephrine group. After tracheal intubation, the maximal average
release, hypotension, and bradycardia. increase was 8% in SBP and 11% DBP in dexmedetomidine
group as compared to 40% and 25%, respectively, in the
Stimulation of α2 A and α2 C in locus ceruleus causes control group. Similarly, the average increase in HR was
sedation. In the spinal cord, activation of both α2 A 7% and 21% in the dexmedetomidine and control groups,
and α2 C receptors directly reduce pain transmission by respectively. In our study, 1 min after laryngoscopy and
reducing the release of substance P. Looking at these subsequent intubation SBP and DBP was 12.8% and
pharmacological properties, it has been evaluated in the 9.7% below baseline values. Similarly, HR remained 8.13%
past to assess its effect on hemodynamic responses in below baseline in dexmedetomidine group (P < 0.001).
patients undergoing laparoscopic surgeries. The molecule So, in our study, attenuation of the pressor response is
has been used in infusion form with or without bolus better than reference study may be due to a higher dose
dose. Infusion rates varying from 0.1 to 10 mcg/kg/h13-15 of intravenous fentanyl 2 mcg/kg versus 1 mcg/kg used
have been studied. However, with higher dose infusion in induction. Similarly, we used intravenous midazolam
of dexmedetomidine, high incidence of adverse cardiac 0.03 mg/kg versus fixed dose of 1 mg in reference study
effects have been observed.15 A biphasic response to for induction of anesthesia.
blood pressure occurs with a bolus dose.10 Initially, there
occurs hypertension followed by fall in blood pressure. CONCLUSION
This response is seen often more in young and healthy
patients.16 Stimulation of α2 B receptors in vascular Dexmedetomidine (1 mcg/kg) serves as a very useful
smooth muscles is said to be responsible for this. anesthesia adjuvant to control hemodynamic stress
Low-dose infusion of 0.25-0.5 mcg/kg/h results in an response to laryngoscopy and intubation, without any
amonophasic response of 10-15% fall in mean arterial significant adverse effects. Efficacy of dexmedetomidine
blood pressure and pulse rate.10 Furthermore, in low dose, in attenuation of the pressor response compared to
dexmedetomidine exhibits linear kinetics, meaning that a intravenous lignocaine (1.5 mg/kg) is significantly higher
constant amount of drug is eliminated per hour rather in ASA-I and II patients with respect to HR, SBP, DBP,
than a constant fraction of the drug. Our study confirms and MAP.
the fact that critical incidences such as laryngoscopy and
intubation do significantly increase the HR, SBP, DBP,
and MAP in patients and dexmedetomidine attenuates this
REFERENCES
sympathoadrenal response and provides hemodynamic 1. Miller R, editor. Airway management. In: Miller’s Anesthesia. VIth ed.
stability.17,18 The effective attenuation dose with minimum Philadelphia: Churchill Livingstone; 2005. p. 1647-8.
side effects noted in our study was 1 mcg/kg infusion over 2. Burstein CL, Lopinto FJ, Newman W. Electrocardiographic studies during
endotracheal intubation during usual routine techniques. Anesthesiology
10 min. Apart from providing stress response attenuation, 1950;11:224.
the added effects of dexmedetomidine are sedation and 3. Miller Forbes A, Dally F. Acute hypertension during induction of anesthesia

159 International Journal of Scientific Study | December 2015 | Vol 3 | Issue 9

 Sale and Shendage: Comparative Study of Lignocaine and Dexmedetomidine in Attenuation of Pressor Response to
Laryngoscopy and Intubation

and endotracheal intubation in normotensive patients. Br J Anaesth receptor agonist dexmedetomidine on hemodynamic response in direct
1970;42:618. laryngoscopy. Open Otorhinolaryngol J 2007;1:5‑11.
4. Prys-Roberts C, Greene LT, Meloche R, Foex P. Studies of anesthesia in 12. Gurbet A, Basagan-Mogol E, Turker G, Ugun F, Kaya FN, Ozcan B.
relation to hypertension, hemodynamic consequences of induction and Intraoperative infusion of dexmedetomidine reduces perioperative analgesic
endotracheal intubation. Br J Anaesth 1971;43:531-47. requirements. Can J Anaesth 2006;53:646-52.
5. Reid LC, Brace DE. Irritation of respiratory tract and its reflex effects upon 13. Feld JM, Hoffman WE, Stechert MM, Hoffman IW, Ananda RC. Fentanyl
the heart. Anesth Analg 1940;70:157. or dexmedetomidine combined with desflurane for bariatric surgery. J Clin
6. Takeshima K, Noda K, Higaki M. Cardiovascular response to rapid Anesth 2006;18:24-8.
anesthesia induction and endotracheal intubation. Anesth Analg 14. Ramsay MA, Saha D, Hebeler RF. Tracheal resection in the morbidly obese
1987;66:1036. patient: The role of dexmedetomidine. J Clin Anesth 2006;18:452-4.
7. Khan ZP, Munday IT, Jones RM, Thornton C, Mant TG, Amin D. Effects 15. Tufanogullari B, White PF, Peixoto MP, Kianpour D, Lacour T,
of dexmedetomidine on isoflurane requirements in healthy volunteers  1: Griffin  J, et al. Dexmedetomidine infusion during laparoscopic
Pharmacodynamic and pharmacokinetic interactions. Br J Anaesth bariatric surgery: The effect on recovery outcome variables. Anesth
1999;83:372-80. Analg 2008;106:1741-8.
8. Hall JE, Uhrich TD, Barney JA, Arain SR, Ebert TJ. Sedative, amnestic, 16. Haselman MA. Dexmedetomidine: A useful adjunct to consider in some
and analgesic properties of small‑dose dexmedetomidine infusions. Anesth high-risk situations. AANA J 2008;76:335-9.
Analg 2000;90:699‑705. 17. Bhattacharjee DP, Nayek SK, Dawn S, Bandopadhyay G, Gupta K.
9. Carollo DS, Nossaman BD, Ramadhyani U. Dexmedetomidine: A review of Effects of dexmeditomidine on haemodynamics in patients undergoing
clinical applications. Curr Opin Anaesthesiol 2008;21:457-61. laparoscopic cholecystectomy – A comparative study. J Anaesth Clin
10. Bloor BC, Ward DS, Belleville JP, Maze M. Effects of intravenous Pharmacol 2010;2:45‑8.
dexmedetomidine in humans. II. Hemodynamic changes. Anesthesiology 18. Keniya VM, Ladi S, Naphade R. Dexmedetomidine attenuates
1992;77:1134‑42. sympathoadrenal response to tracheal intubation and reduces perioperative
11. Isik B, Arslan M, Özsoylar O, Akçabay M. The effects of α2‑adrenergic anaesthetic requirement. Indian J Anaesth 2011;55:352-7.

How to cite this article: Sale HK, Shendage VJ. Lignocaine and Dexmedetomidine in Attenuation of Pressor Response to Laryngoscopy
and Intubation: A Prospective Study. Int J Sci Stud 2015;3(9):155-160.

Source of Support: Nil, Conflict of Interest: None declared.

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