DEXMEDETOMIDINE VERSUS MAGNESIUM SULFATE FOR BLUNTING CARDIOVASCULAR RESPONSE TO LARYNGOS COPY AND ENDOTRACHEAL INTUBATION IN GENERAL ANAESTHESIA.
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Keywords
Dexmedetomidine, Magnesium sulfate, General anaesthesia
Abstract
Direct laryngoscopy and endotracheal intubation frequently induce cardiovascular stress response in form of tachycardia and hypertension due to reflex sympathetic stimulation which in turn leads to increased plasma norepinephrine concentration. Numerous drugs like opioids, calcium channel blockers, alpha2 agonists, magnesium sulphate, local anesthetics used to blunt the stress response. Magnesium sulphate, as the physiological calcium antagonist for membrane calcium channels can modify many calcium mediated response. The ability of Mg2+ ions to inhibit the release of catecholamines from both the adrenal glands and peripheral adrenergic nerve terminals has been known and is now well established. Dexmedetomidine is an alpha2 agonist stimulate alpha2 receptor in lateral reticular nucleus result in reduce central sympathetic outflow and blunting hemodynamics response to unpleasant stimulation. Pretreatment with dexmedetomidine provides sedation and analgesia also reduces sympathetic tone and attenuate the stress response to anesthesia and surgery.
References
2. Mahajan L, Kaur M, Gupta R, Aujla KS, Singh A, Kaur A. Attenuation of the pressor responses to laryngoscopy and endotracheal intubation with intravenous dexmedetomidine versus magnesium sulphate under bispectral index-controlled anaesthesia: A placebo-controlled prospective randomised trial. Indian Journal of Anaesthesia. 2018 May; 62(5):337.
3. Kotwani DM, Kotwani MB, Hiwarkar A. A prospective randomised study comparing intravenous magnesium sulphate and sublingual nitroglycerine spray in attenuating haemodynamic responses to laryngoscopy and intubation. Int J Clin Trials. 2018 Apr; 5:90.
4. Balata AA, Abdel Latif HK, Waly SH, Mohamed AB. dexmedetomidine versus magnesium sulphate or lidocaine for blunting stress response to direct laryngoscopy and endotracheal intubation in abdominal surgeries. Zagazig University Medical Journal. 2018 Nov 1;24(6):492-500.
5. Chaithanya K, Vaddineni J, Reddy N, Gandra S, Kumar C, Rao V, Sekhar V. A comparative study between IV 50% magnesium sulphate and dexmedetomidine for attenuation of cardiovascular stress response during laryngoscopy and endotracheal intubation. Journal of Evolution of Medical and Dental Sciences. 2014 Aug 4; 3(32):8741-50.
6. Khan BA, Mahtalath MD. Attenuation of cardiovascular responses to laryngoscopy and intubation-dexmedetomidine vs. magnesium sulfate. J Evid Based Med Healthc. 2017; 4:495-8.
7. Sharma B, Goyal S, Yadav SS, Tandon N, Kothari D. Effect of intravenous dexmedetomidine for prevention of perioperative shivering in transurethral resection of prostate surgery: A randomized Prospective Study. J Med Sci Clin Res. 2020; 80(3):709-15.
8. David D, Shanmugapriya V, Anuradha N, Anandhakumar G. Comparison of Esmolol and Magnesium Sulphate for Attenuation of Hemodynamic Stress Response to Laryngoscopy and Intubation in Elective ENT Surgeries. Indian Journal of Anaesthesia and Analgesia. 2018 Feb;5(2):186-91.
10. Sharma J, Sharma V, Gupta S. Comparative study of magnesium sulphate and esmolol in attenuating the pressor response to endotracheal intubation in controlled hypertensive patients. Journal of Anaesthesiology Clinical Pharmacology. 2006 Jul 1; 22(3):255-9.
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Dr. Richa Patel
MBBS, MD, Associate professor, Department of Anaesthesiology, GMERS Medical college, Navsari
Dr. Vijeta Tandel
MBBS, MD (Assistant Professor, Department of Anaesthesiology), GMERS Medical college, Valsad
Dr. Ushma Shah
MBBS, DA, DNB (Assistant Professor, Department of Anaesthesiology), GMERS Medical college, Gandhinagar