Year: 2026 | Month: June | Volume: 16 | Issue: 6 | Pages: 117-126
DOI: https://doi.org/10.52403/ijhsr.20260613
Comparison of Dexmedetomidine and Fentanyl for Attenuation of Hemodynamic Response During Laryngoscopy and Intubation: A Prospective Randomized Controlled Study
G Anil Kumar1, Manisha Narendra Vaghela2, BP Mallanna3, Dinesh M4, MM Ananya5
1,2,3,4,5Department of Anaesthesiology, District Hospital, Ballari, Karnataka, India.
Corresponding Author: BP Mallanna
ABSTRACT
Background: Laryngoscopy and endotracheal intubation provoke significant sympathetic stimulation, leading to transient hypertension, tachycardia, and potentially dangerous arrhythmias. While generally tolerated in healthy individuals, these hemodynamic responses pose substantial risks in patients with cardiovascular comorbidities or elevated intracranial pressure. Fentanyl and dexmedetomidine are commonly used to attenuate these responses, but direct comparative evidence remains limited.
Objective: To compare dexmedetomidine (0.5 mcg/kg) and fentanyl (2 mcg/kg) in attenuating hemodynamic responses during laryngoscopy and intubation.
Methods: This prospective, randomized controlled study was conducted at the Department of Anaesthesiology, District Hospital, Ballari, Karnataka, India, from July 2023 to June 2024. Sixty-six ASA I–II patients aged 18–60 years with Mallampati Grade I–II airways were randomized into two groups: Group D (n=33) received dexmedetomidine 0.5 mcg/kg and Group F (n=33) received fentanyl 2 mcg/kg, both diluted in 10 mL normal saline and administered intravenously over 10 minutes. Heart rate, systolic blood pressure (SBP), diastolic blood pressure (DBP), and mean arterial pressure (MAP) were recorded at baseline, post-infusion intervals, and up to 10 minutes post-intubation. Data were analyzed using paired and unpaired t-tests, with p<0.05 considered significant.
Results: Demographic characteristics were comparable between groups. Dexmedetomidine demonstrated significantly superior attenuation of hemodynamic responses compared to fentanyl. At 5 minutes post-intubation, heart rate in Group D was only 1.9 bpm above baseline versus 26.2 bpm elevation in Group F (p<0.001). SBP was significantly lower in Group D at 3, 5, 7, and 10 minutes post-intubation (p<0.001 at 3–7 min; p<0.001 at 5 min: 126.3±9.2 vs 143.5±7.3 mmHg). MAP differences were also significant from 3 minutes onward, with Group D showing 95.9±7.3 mmHg versus 106.7±5.3 mmHg in Group F at 5 minutes (p<0.001). SpO₂ remained stable in both groups. One patient in Group F experienced post-extubation laryngospasm; no significant adverse events occurred in Group D
Conclusion: Dexmedetomidine provides superior and more consistent attenuation of hemodynamic responses compared to fentanyl, with better cardiovascular stability.
Key words: Dexmedetomidine, Fentanyl, Laryngoscopy, Intubation, Hemodynamic response