A Comparison between Effectiveness of Intravenous Magnesium Sulphate and Dexmedetomidine on Attenuation of Haemodynamic Stress Response to Laryngoscopy and Endotracheal Intubation: A Randomised Control Trail

Introduction: Hemodynamic stress responses to laryngoscopy and endotracheal intubation, can pose significant risks, especially in patients with cardiovascular comorbidities. This study aimed to compare the efficacy of magnesium sulphate and dexmedetomidine in attenuating these responses.

Methods: A randomized controlled trial was conducted on 80 patients (40 in each group), aged 18-60 years, undergoing elective surgeries under general anesthesia at Meenakshi Mission Hospital, Madurai. Patients were randomized into two groups: Group M received 30 mg/kg magnesium sulphate, and Group D received 0.75 mcg/kg dexmedetomidine. Hemodynamic parameters (heart rate, systolic, diastolic, and mean arterial pressure) were measured at baseline, after drug administration, and at 1, 3, and 5 minutes post-intubation. Data were analyzed using Student t-tests and chi-square tests, with p < 0.05 considered significant.

Results: Dexmedetomidine (Group D) showed significantly lower heart rate and systolic blood pressure at all post-intubation intervals compared to magnesium sulphate (Group M). Specifically, Group D demonstrated lower mean heart rates at 3 minutes post-drug (77.3 ± 15.8 vs 86.5 ± 13.0; p=0.006) and 5 minutes post-intubation (72.1 ± 9.8 vs 77.1 ± 11.5; p=0.04). Systolic blood pressure was also significantly lower in Group D at 1 minute post-intubation (123.7 ± 16.1 vs 136.9 ± 12.6; p=0.001). Complication rates were low in both groups, though hypotension occurred more frequently in Group D (10% vs 2.5%, p=0.166).

Conclusion: Dexmedetomidine was more effective than magnesium sulphate in attenuating the hemodynamic stress response to laryngoscopy and intubation, with a slightly higher incidence of hypotension. Both agents were generally safe and well-tolerated.