Comparison of the efficacy of intravenous lignocaine and intravenous dexmedetomidine in attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation.

Abstract

Objective: To compare the efficacy of intravenous lignocaine and dexmedetomidine in attenuating the hemodynamic stress response to laryngoscopy and endotracheal intubation. Study Design: Randomized Controlled Trial. Setting: Department of Anaesthesia, Fauji Foundation Hospital, Rawalpindi. Period: Jul-2025 to Sep-2025. Methods: A total of 170 patients aged18 years or above, belonging to ASA I or II and planned for elective surgeries under general anesthesia were randomized into two groups of 85 patients each. In Group L, patients received IV lignocaine (1.5 mg/kg, 3 minutes before intubation) while patients in Group D received IV dexmedetomidine (1 µg/kg infused over 10 minutes before induction). Hemodynamic parameters (systolic and diastolic blood pressure, and HR) were recorded at baseline and at 1, 3, 5 and 10 minutes following intubation. Efficacy was defined as maintaining the hemodynamic parameters within 20% of baseline values while the primary outcome was set as the peak change in these hemodynamic parameters within the first 5 minutes. Results: Mean age of patients was 47.25±8.15 years. Male patients were 57.06% while female patients 42.94% of total study population. The results of primary outcomes showed that the peak change in systolic and diastolic blood pressure and heart rate were significantly lower in Group D compared to the Group L (p<0.0001 for all parameters). Efficacy was achieved in 82.4% of patients in Group D versus 65.9% in Group L (p=0.01). Conclusion: Dexmedetomidine is more effective than lignocaine in attenuating the hemodynamic stress response to laryngoscopy and intubation.