The effect of intranasal dexmedetomidine on hemodynamic disturbances caused by laryngoscopy and endotracheal intubation.

Background: Induced stimulation while endotracheal intubating affects hemodynamic status. The present study compares the hemodynamic changes caused by endotracheal intubating after administering two doses of intranasal Dexmedetomidine.

Methods: In an experimental (before-after) trial, 88 patients undergoing general anesthesia enrolled in the study. The Iranian Register of Clinical Trial (IRCT) code of the study was IRCT20160307026950N15 (https://en.irct.ir/trial/39269). Patients were allocated to two intervention groups and one control group by random. Intranasal Dexmedetomidine and Normal saline 0.9% were administrated 30 minutes before induction of anesthesia. (1 μg/kg Dexmedetomidine in group 1, 2 μg/kg Dexmedetomidine in group 2 and 1 mg Normal saline 0.9% in group 3). Vital signs and hemodynamic parameters were measured and recorded in minutes 1, 3, 5, and 10th after induction. Data analysis was done by ANOVA and Chi-square tests.

Results: Heart rate, systolic and diastolic blood pressure, and mean arterial pressure were reduced in patients receiving dexmedetomidine (P<0.05), but there were no significant changes in the control group. In arterial oxygenation (P>0.05), there was no significant difference between the three groups in the arterial blood oxygen amount.

Conclusion: Premedication of intranasal dexmedetomidine influences the hemodynamic changes due to anesthesia induction. The dose of 2 µg/kg is better than one µg/kg in improving the hemodynamic state following intubation.