Comparison of Dexmedetomidine, Lidocaine, and Fentanyl in Attenuation Hemodynamic Response of Laryngoscopy and Intubation in Patients Undergoing Cardiac Surgery

Maziar Mahjoubifard, Mehdi Heidari, Maryam Dahmardeh, Seyed Bashir Mirtajani, Alireza Jahangirifard, Maziar Mahjoubifard, Mehdi Heidari, Maryam Dahmardeh, Seyed Bashir Mirtajani, Alireza Jahangirifard

Abstract

Materials and methods: This clinical trial was conducted on 90 patients, aged 30-70 years, who had heart surgery. The participants were categorized into three groups. Group D received 1 µg/kg intravenous dexmedetomidine in 10 minutes, group L received 1.5 mg/kg lidocaine (1%) 90 seconds before intubation, and group F received 2 µg/kg fentanyl. The vital signs (HR, SBP, DBP, and MAP) were measured before intubation and 1st, 3rd, 5th, and 10th minutes after intubation. Data were analyzed with SPSS 19 software (chi-square, one-way ANOVA, or Kruskal-Wallis).

Results: The age (P=0.389) and gender distributions of patients were similar in all three groups. Dexmedetomidine significantly attenuated HR in the 3rd (P=0.001), 5th (P=0.001), and 10th (P=0.003) minutes after intervention. It also reduced the systolic blood pressure in the 5th (P=0.024) and 10th (P=0.006) minutes. This reduction was significantly higher in the dexmedetomidine group than that in the two other groups. In addition, dexmedetomidine caused a greater reduction in MAP in the 1st (P=0.048), 5th (P=0.0001), and 10th (P=0.0001) minutes. Discussion. All three medications were effective in controlling HR; however, dexmedetomidine caused bradycardia in the 3rd, 5th, and 10th minutes. Lidocaine resulted in an increase in MAP in the 1st minute after intubation; whereas, dexmedetomidine reduced MAP at the 5th and 10th minutes after intubation. Changes in blood pressure and mean arterial pressure in the fentanyl group was lower than the two other groups.

Conclusion: As a result, dexmedetomidine was not suitable for hemodynamic control and led to hypotension and bradycardia; on the other hand, fentanyl was more effective than two other medications in patients undergoing cardiac surgery. This trial is registered with IRCT2017013132320N1.

Conflict of interest statement

The authors declare that there are no conflicts of interest.

Copyright © 2020 Maziar Mahjoubifard et al.

Figures

Figure 1
Figure 1
Consort chart.
Figure 2
Figure 2
Comparison of HR in the 1st, 3rd, 5th, and 10th minutes after intubation with before intubation in each group.
Figure 3
Figure 3
Comparison of SBP in the 1st, 3rd, 5th, and 10th minutes after intubation with before intubation in each group.
Figure 4
Figure 4
Comparison of DBP in the 1st, 3rd, 5th, and 10th minutes after intubation with before intubation in each group.
Figure 5
Figure 5
Comparison of MAP in the 1st, 3rd, 5th, and 10th minutes after intubation with before intubation in each group.

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