Comparative study between dexmedetomidine, magnesium sulfate, and lidocaine on the pressor response to laryngoscopic intubation and optic nerve sheath diameter measurement in laparoscopic gynecological surgery
Sara M. Mansour, Ahmed I. Abd El Sabour, Hamdy Abbas, Armia Magdi, Yara H. AbbasAbstract
Background:
The use of laryngoscope and intubation in general anesthesia can cause stress response like hypertension and tachycardia. Intravenous (IV) dexmedetomidine, magnesium sulfate (MgSO4), and lidocaine have been used to compare their effect on pressor response, hemodynamics, and optic nerve sheath diameter (ONSD).
Methods:
One hundred and two female patients slated for elective gynecologic laparoscopic surgery under general anesthesia were involved in this randomized, double-blinded study. They were randomized to receive IV dexmedetomidine (Group D, n = 34), IV magnesium SO4 (Group M, n = 34), or IV lidocaine (Group L, n = 34). Heart rate (HR) and mean arterial pressure were assessed prior to and following medication usage, prior to and following the induction of anesthesia, following intubation (cuff inflation (1 minute), and 5 and 10 minutes following intubation. At the same timeframe, the ONSD measurement was conducted.
Results:
After intubation for 1 min (cuff inflation), Group D had the lowest HR compared to groups M and L and also Mean blood pressure (MBP) was lower in group D and group M than group L. At 5 min and 10 min after intubation, HR was lower in group D than group M and group L and MBP was lowest in group D than group M and group L. ONSD was lower in group D than group M and group L at 1, 5, and 10 min after intubation.
Conclusions:
IV dexmedetomidine offers the best control on hemodynamics and ONSD responses during laryngoscopic intubation than IV MgSO4 and lidocaine.