COMPARATIVE STUDY OF DEXMEDETOMIDINE AND FENTANYL CITRATEAS BOLUS DOSE FOR STRESS ATTENUATION DURING NASAL ENDOTRACHEAL INTUBATION IN ONCOLOGICAL PATIENTS

Background: Various pharmacological agents were used to decrease intubation stress response, with their own limitations.Dexmedetomidine - alpha-2 agonist with analgesic action,less hypotension, better heart rate control and no respiratory depression in post intubation phase than fentanyl. We explore the use of non-opioid analgesic drugs toboth to reduce the risk of developing opioid addictionand its side effects. Objective: It was to compare the hemodynamic effect of dexmedetomidine and fentanyl ininduction techniques and the incidence of side effects in patients scheduled for head and neck cancer surgery. Method: In this prospective randomized, double blinded, control study one hundred patients ofASA physical status I &II, aged 18 to 60, MPG I and IIposted for elective head&neck cancer surgery were included.Before induction of anesthesia, patients were randomly divided into two equal groups. Group D received dexmedetomidine (1 μg/kg) and group F received fentanyl (2 μg/kg) over 10 minutesIV. No stimuli in any form allowed for 10 minutes of induction. Hemodynamic data collected till 15 minutes of induction. Result: In group F, heart rate increased following laryngoscopy and endotracheal intubation and returned back to normal after 10 minutes. The attenuation in systolic, diastolic and mean arterial pressure was significantly better in the groupD than the group F. From3rd minute onwards after intubation,hemodynamic values werelower in group D than group F(p < 0.05). Antihypertensive drug requirement was higher in group F (p value < 0.05). Conclusion: Dexmedetomidine (1mcg/kg) is better than fentanyl for maintenance hemodynamic stability following laryngoscopy and nasal intubation and avoids opioid‑related adverse effects, tolerance and hyperalgesia.