The Effect of Intranasal Dexmedetomidine on Hemodynamic Responses during Double-Lumen Tube Insertion: A Randomized Controlled Trial
4 affiliations
- 1Department of Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India
- 2Department of Cardiac Anaesthesia, Christian Medical College, Vellore, Tamil Nadu, India
- 3Department of Anaesthesia, Believers Church Medical College and Hospital, Thiruvalla, Kerala, India
- 4Department of Cardiothoracic Surgery, Christian Medical College, Vellore, Tamil Nadu, India
Abstract
Background:: Thoracic surgeries require controlled lung collapse for optimal visualization, achieved through Double-Lumen Tube (DLT) intubation for one-lung ventilation (OLV). DLT insertion triggers significant sympathetic activation, potentially causing cardiovascular complications and cerebrovascular events. This study aimed to investigate the efficacy of intranasally administered Dexmedetomidine in attenuating hemodynamic perturbations associated with laryngoscopy and DLT placement.
Methods:: This randomized controlled study was done in a tertiary care center in South India. Patients coming for thoracic surgery requiring DLT insertion were recruited and randomized into Group A and Group B (n = 25). Group A received 1 mcg/kg Intranasal Dexmedetomidine, and Group B received Intranasal Normal saline 45 minutes prior to induction of anaesthesia using a mucosal atomizer device. Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR), were recorded at different time points up to 30 minutes after intubation.
Results:: Patients in the dexmedetomidine group had a lower heart rate before intubation (84.92 ± 0.0349) than those in the placebo group (96.48 ± 0.0349). A statistically significant reduction in heart rate was observed in Group A at intubation (T0) and at subsequent time points (T1, T2, T3, T20, T25, and T30). SBP and DBP decreased before intubation, after which subsequent readings showed a statistically significant difference (P = 0.000). Patients in Group A required significantly less Propofol to maintain BP within 20% of baseline.
Conclusion:: Administering a single dose of intranasal dexmedetomidine at 1 mcg/kg before induction effectively manages the hemodynamic response during laryngoscopy.
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BibTeX
@article{gilbert2026effect,
title = {{The Effect of Intranasal Dexmedetomidine on Hemodynamic Responses during Double-Lumen Tube Insertion: A Randomized Controlled Trial}},
author = {Roys P. Gilbert and Suda N. Kumar and Ilangovan Panchanathan and Anu K. Thomas and Kishorkumar Dhanaboopathy and Balaji Kuppuswamy and Santhosh R. Benjamin and Korah T. Kuruvila and Vinay M. Rao and Nishok David},
journal = {Annals of Cardiac Anaesthesia},
year = {2026},
month = oct,
doi = {10.4103/aca.aca_52_26},
url = {https://doi.org/10.4103/aca.aca_52_26},
note = {CC BY-NC-SA 4.0},
}
RIS
TY - JOUR
TI - The Effect of Intranasal Dexmedetomidine on Hemodynamic Responses during Double-Lumen Tube Insertion: A Randomized Controlled Trial
AU - Roys P. Gilbert
AU - Suda N. Kumar
AU - Ilangovan Panchanathan
AU - Anu K. Thomas
AU - Kishorkumar Dhanaboopathy
AU - Balaji Kuppuswamy
AU - Santhosh R. Benjamin
AU - Korah T. Kuruvila
AU - Vinay M. Rao
AU - Nishok David
PY - 2026
DA - 2026/10/12
JO - Annals of Cardiac Anaesthesia
DO - 10.4103/aca.aca_52_26
UR - https://doi.org/10.4103/aca.aca_52_26
AB - Background:: Thoracic surgeries require controlled lung collapse for optimal visualization, achieved through Double-Lumen Tube (DLT) intubation for one-lung ventilation (OLV). DLT insertion triggers significant sympathetic activation, potentially causing cardiovascular complications and cerebrovascular events. This study aimed to investigate the efficacy of intranasally administered Dexmedetomidine in attenuating hemodynamic perturbations associated with laryngoscopy and DLT placement. Methods:: This randomized controlled study was done in a tertiary care center in South India. Patients coming for thoracic surgery requiring DLT insertion were recruited and randomized into Group A and Group B (n = 25). Group A received 1 mcg/kg Intranasal Dexmedetomidine, and Group B received Intranasal Normal saline 45 minutes prior to induction of anaesthesia using a mucosal atomizer device. Hemodynamic parameters, including systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and heart rate (HR), were recorded at different time points up to 30 minutes after intubation. Results:: Patients in the dexmedetomidine group had a lower heart rate before intubation (84.92 ± 0.0349) than those in the placebo group (96.48 ± 0.0349). A statistically significant reduction in heart rate was observed in Group A at intubation (T0) and at subsequent time points (T1, T2, T3, T20, T25, and T30). SBP and DBP decreased before intubation, after which subsequent readings showed a statistically significant difference (P = 0.000). Patients in Group A required significantly less Propofol to maintain BP within 20% of baseline. Conclusion:: Administering a single dose of intranasal dexmedetomidine at 1 mcg/kg before induction effectively manages the hemodynamic response during laryngoscopy.
SN - 0971-9784
SN - 0974-5181
ER -