Comparing Intravenous versus Nebulized either Dexmedetomidine or Lidocaine for Attenuation of the Hemodynamic Responses to Laryngoscopy and Intubation
Khayr, A., Taha, Z., Nasr, Y., Mohamed, M. (2023). Comparing Intravenous versus Nebulized either Dexmedetomidine or Lidocaine for Attenuation of the Hemodynamic Responses to Laryngoscopy and Intubation. EKB Journal Management System, (), -. doi: 10.21608/zumj.2023.246769.2997
Ayoub Mohammed Masoud Khayr; Zaki Saleh Taha; Yasser Mohamed Nasr; Mohamed Gaber Mohamed. "Comparing Intravenous versus Nebulized either Dexmedetomidine or Lidocaine for Attenuation of the Hemodynamic Responses to Laryngoscopy and Intubation". EKB Journal Management System, , , 2023, -. doi: 10.21608/zumj.2023.246769.2997
Khayr, A., Taha, Z., Nasr, Y., Mohamed, M. (2023). 'Comparing Intravenous versus Nebulized either Dexmedetomidine or Lidocaine for Attenuation of the Hemodynamic Responses to Laryngoscopy and Intubation', EKB Journal Management System, (), pp. -. doi: 10.21608/zumj.2023.246769.2997
Khayr, A., Taha, Z., Nasr, Y., Mohamed, M. Comparing Intravenous versus Nebulized either Dexmedetomidine or Lidocaine for Attenuation of the Hemodynamic Responses to Laryngoscopy and Intubation. EKB Journal Management System, 2023; (): -. doi: 10.21608/zumj.2023.246769.2997

Comparing Intravenous versus Nebulized either Dexmedetomidine or Lidocaine for Attenuation of the Hemodynamic Responses to Laryngoscopy and Intubation

Zagazig University Medical Journal
Articles in Press, Accepted Manuscript, Available Online from 13 November 2023  XML
Document Type: Original Article
DOI: 10.21608/zumj.2023.246769.2997
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Authors
Ayoub Mohammed Masoud Khayr email 1; Zaki Saleh Taha2; Yasser Mohamed Nasr2; Mohamed Gaber Mohamedorcid 3
1MBBCH, Faculty of Medicine, Benghazi University Libya.
2Professor of Anesthesia, Intensive Care & Pain management, Faculty of Medicine, Zagazig University, Alsharkia, Egypt
3Lecturer of Anesthesia, Intensive Care & Pain management, Faculty of Medicine, Zagazig University, Alsharkia, Egypt
Abstract
Background: To reduce laryngoscopy effects and risks of hemodynamic perturbations, nebulized dexmedetomidine (Neb-Dex) could be a useful alternative to conventional intravenous medications. This study compared the effects of intravenous versus nebulized, either dexmedetomidine or lidocaine, on attenuation of hemodynamic responses that follow laryngoscopy and endotracheal intubation.

Methods:

In a prospective double-blinded clinical study, 92 cases were allocated randomly into four groups, 23 cases in each group: Group 1: (ND) Nebulized Dexmedetomidine, Group 2: (NL) Nebulized Lidocaine, Group 3: (VD) IV Dexmedetomidine, and Group 4: (VL) IV Lidocaine. Changes in patients' serum cortisol levels before and after laryngoscopy were primary outcome, while secondary outcome parameters included changes in systolic blood pressure (SBP), diastolic blood pressure (DBP), heart rates (HR), as well as mean arterial pressure (MAP) basally and after laryngoscopy and endotracheal intubation.

Results:

There was a significant decrease of serum Cortisol level in groups (VD) & (ND) at ten minutes 13.35±1.7 & 13.59±2 mcg/dl in comparison to basal time 13.91±1.4 & 13.76±1.9 mcg/dl respectively, p<0.05. In comparison, there was a significant increase in serum Cortisol ug/dl in group (NL)&group (VL) at ten minutes 13.79±1.22 & 14.01±1.42 mcg/dl in comparison to basal time 13.49±1.07 & 13.66±1.52 mcg/dl respectively, p<0.05. There was a significant decline in heart rates systolic, diastolic, mean arterial pressures in group VD compared with groups NL, ND, and VL at different time intervals (p<0.05 in each).

Conclusion:

hemodynamic response to laryngoscopy and intubation can be mitigated, to varying degrees, by administering either intravenous or nebulized lidocaine or dexmedetomidine.
Keywords
Nebulized; Dexmedetomidine; Lidocaine; Laryngoscopy; Intubation
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