title: The efficacy of labetalol vs dexmedetomidine for attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation.
abstract: OBJECTIVE
  To assess the effectiveness of labetalol vs dexmedetomidine for attenuation of hemodynamic stress response to laryngoscopy and endotracheal intubation.
  
  
  METHODS
  Prospective, randomized, controlled, observer-blinded study.
  
  
  METHODS
  This study was carried out in Tanta University Hospital.
  
  
  METHODS
  Ninety patients of both sexes; American Society of Anesthesiologists physical status I and II; age range from 20 to 60 years; scheduled for elective surgery under general anesthesia.
  
  
  METHODS
  Patients were divided into 3 groups (30 each). Group A received 1 μg/kg of dexmedetomidine as intravenous (IV) infusion, group B received labetalol 0.25mg/kg IV, and group C received 10mL saline IV.
  
  
  METHODS
  The groups were compared for heart rate (HR), mean arterial pressure (MAP), and rate pressure product (RPP). Hemodynamic parameters were recorded during the preinduction; after induction; at intubation; and at 1, 3, 5, 10, and 15minutes. The primary outcomes were hemodynamic changes (HR, MBP, and RPP), and the secondary outcome was propofol dose requirement for induction of general anaesthesia.
  
  
  RESULTS
  Significant decrease (P < .05) in HR, MBP, and RPP in groups A and B in comparison with group C and in group A in comparison with group B. Just before intubation, there was a significant decrease (P < .05) in HR, MBP, and RPP in groups A and B in comparison with group C. In group C, there was a significant increase in HR, MBP, and RPP at all points when compared with the baseline. In group A, the mean propofol induction dose (mg) was statistically significantly low as compared with that in groups B and C.
  
  
  CONCLUSIONS
  Dexmedetomidine attenuates the hemodynamic stress response to laryngoscopy and intubation more effectively compared with labetalol without any deleterious effects. Furthermore, dexmedetomidine decreases dose of propofol for induction of anesthesia as guided by bispectral index.
authors.affiliation: Department of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University. Electronic address: nagat_elshmaa@yahoo.com.
authors.forename: Nagat S
authors.initials: NS
authors.lastname: El-Shmaa
authors.affiliation: Department of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University. Electronic address: ghadadido@yahoo.com.
authors.forename: Ghada F
authors.initials: GF
authors.lastname: El-Baradey
mesh_terms: D058647:Adrenergic alpha-2 Receptor Agonists / Q000494:pharmacology; D000319:Adrenergic beta-Antagonists / Q000494:pharmacology; D000328:Adult; D020927:Dexmedetomidine / Q000494:pharmacology*; D005260:Female; D006439:Hemodynamics / Q000187:drug effects*; D006801:Humans; D007442:Intubation, Intratracheal / Q000009:adverse effects*; D007741:Labetalol / Q000494:pharmacology*; D007828:Laryngoscopy / Q000009:adverse effects*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016037:Single-Blind Method; D013312:Stress, Physiological / Q000187:drug effects*; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D000319:Adrenergic beta-Antagonists; D020927:Dexmedetomidine; D007741:Labetalol
keywords: Dexmedetomidine; Hemodynamic stress response; Intubation; Labetalol; Laryngoscopy