{'fraction_non_alphanumeric': 0.04181985294117647, 'fraction_numerical': 0.03125, 'mean_word_length': 5.1671388101983, 'pattern_counts': {'":': 0, '<': 3, '<?xml version=': 0, '>': 1, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 0, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
Dexmedetomidine for Attenuation of Sympathomimetic Response to Laryngoscopy and Tracheal Intubation in Neurosurgical Patients

Background: Stress responses caused by noxious stimuli during laryngoscopy and tracheal intubation can incite harmful effects, especially in neurosurgical patients. Among various drug regimens and techniques tried for obtunding such consequences, dexmedetomidine, an α-2 receptor agonist mediating its action through α-2A receptors located in locus coeruleus, inhibits noradrenaline release thus decreases such sympathetic activity. Aim and Objective: To evaluate the effect of a single preoperative dose of dexmedetomidine 1 μg/kg slow infusion on hemodynamic responses to laryngoscopy and tracheal intubation. Materials and Methods: Sixty patients randomized into two groups of 30 each of age range 20–60 years, the American Society of Anesthesiologists physical Status I and II posted for planned neurosurgical procedures, to receive dexmedetomidine (Group D): 1 μg/kg diluted with 0.9% saline to a total volume of 20 mL, control Group (C): 20 ml 0.9% normal saline, both infused intravenously over 10 min, 3 min before induction. Changes in heart rate (HR), systolic, diastolic, mean arterial pressure (MAP), and any side effect associated with the drug during the study of 20 min of intubation, were observed and statistically analyzed. Results: Insignificant difference (P > 0.05) in demographic criteria. In comparison to the baseline (BL) value, during laryngoscopy, a fall in mean HR by 12.1% in dexmedetomidine group and a rise of 28.39% in control group, reduction in mean systolic blood pressure value 11.40% in dexmedetomidine group, a rise by 19.50% in control group (P < 0.05), a fall in mean diastolic blood pressure by 11.19% in dexmedetomidine, in control group a rise of 16.97%, the difference is statistically significant (P < 0.0001), rise in the mean MAP value in the control group to 18.12% above the BL value but in Group D, it was reduced by 11.29% (P < 0.05). Conclusion: Infusion of dexmedetomidine, in attenuation of hemodynamic response to laryngoscopy and tracheal intubation, is a safe and effective protective method.