COMPARISON OF DEXMEDETOMIDINE - PROPOFOL VERSUS FENTANYL -PROPOFOL ON INDUCTION DOSAGE AND INTUBATION RESPONSE

Background and Objective: Laryngoscopy and endotracheal intubation during general anesthesia can provoke noxious stimuli, leading to laryngosympathetic stimulation, characterized by hypertension, tachycardia, and arrhythmias. This study aims to compare the effectiveness of dexmedetomidine and fentanyl in mitigating the hemodynamic stress responses associated with laryngoscopic endotracheal intubation in adult patients undergoing surgeries under general anesthesia. Materials and Methods: Sixty adult participants aged between 18-55 years of diverse gender representation,, scheduled for elective surgeries under general endotracheal anesthesia, were divided into two groups, each comprising 30 patients. - Group D (Dexmedetomidine):Patients received intravenous (IV) dexmedetomidine at a dose of 1 mcg/kg body weight, diluted to 20 ml of normal saline (NS) IV over 10 minutes using a syringe pump. Group F (Fentanyl Group):Patients received intravenous fentanyl at a dose of 1 mcg/kg body weight, diluted to 20 ml of NS IV over 10 minutes using a syringe pump. Anesthesia induction was accomplished with IV Propofol 2mg/kg and IV vecuronium at a dose of 0.1 mg/kg body weight to facilitate endotracheal intubation. Anesthesia maintenance was achieved with a combination of oxygen, nitrous oxide, 1-2% sevoflurane, and IV vecuronium. Heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at various time intervals. In group F, one minute after laryngoscopy and intubation, there was a rise i Results- n heart rate (HR) by 14 beats per minute (bpm) and an increase in systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) by 2 mmHg each compared to baseline values. Conversely, in group D, HR, SBP, DBP, and MAP decreased significantly by 4 bpm, 23 mmHg, 25 mmHg, and 24 mmHg respectively, compared to baseline values, with a high level of statistical significance (p=0.0001). Both IV Dexmedetomidine at a Interpretation and Conclusiondose of 1 mcg/kg body weight administered over 10 minutes and IV Fentanyl at a dose of 1 mcg/kg body weight administered over 2 minutes prior to induction effectively mitigate the hemodynamic stress response to laryngoscopy and intubation without notable side effects. However, Dexmedetomidine exhibits greater efficacy and superiority over Fentanyl in attenuating the hemodynamic response to laryngoscopy and endotracheal intubation .Group D experienced faster recovery and required less propofol for induction, highlighting a more efficient sedation profile in this group compared to Group F.