Role of Dexmedetomidine in Attenuating Stress Response During Laryngoscopy and Intubation: A Prospective Comparative Study

Background: Laryngoscopy and endotracheal intubation produce sympathetic stimulation, resulting in transient tachycardia and hypertension. Dexmedetomidine, a selective alpha-2 adrenergic agonist, provides sympatholysis and sedation and is used to blunt this peri-intubation stress response. The objective is to evaluate the role of intravenous dexmedetomidine in attenuating haemodynamic stress response during laryngoscopy and endotracheal intubation in adult patients undergoing elective surgery under general anaesthesia. Material and Methods: This prospective comparative study included 60 adult patients at Kamineni Institute of Medical Science, Narketpally, Telangana, India, from August 2024 to July 2025. Patients were divided into two equal groups. Group D received dexmedetomidine and Group C served as the control group. Heart rate, systolic blood pressure, diastolic blood pressure, and mean arterial pressure were recorded at baseline, before induction, at intubation, and after intubation. Adverse events were documented. Results: Baseline demographic and clinical variables were comparable between the groups. At intubation, mean heart rate was lower in Group D than Group C. Systolic blood pressure, diastolic blood pressure, and mean arterial pressure were also significantly lower in Group D during the intubation period and remained better controlled up to 10 minutes after intubation. Tachycardia and hypertension after intubation were less frequent in Group D, while mild bradycardia and hypotension were manageable. Conclusion: Dexmedetomidine effectively attenuated the haemodynamic stress response to laryngoscopy and endotracheal intubation and provided better peri-intubation cardiovascular stability without serious adverse events.

Keywords: Dexmedetomidine; laryngoscopy; endotracheal intubation; stress response; haemodynamic response; general anaesthesia.