The Effect of Dexmedetomidine on Hemodynamic Response during Double-Lumen Tube Insertion: A Randomized Controlled...

Double-lumen tube (DLT) insertion, which is often necessary to isolate the lung in thoracic surgeries, causes a significant and prolonged stress response. This study aims to evaluate the effect of a single preinduction bolus of dexmedetomidine 0.5 mcg/kg on hemodynamic responses to DLT insertion and fiberoptic confirmation.

In this prospective randomized control trial, 60 patients coming for thoracic surgery requiring DLT insertion were recruited. Thirty were assigned to the dexmedetomidine group (A) and 30 to the placebo group (B). Group A received 0.5 mcg/kg dexmedetomidine, and Group B received normal saline over 10 min. Heart rate (HR), systolic blood pressure (SBP), and diastolic blood pressure (DBP) were recorded at baseline, after study drug administration, just before intubation, at intubation, and thereafter at regular intervals up to 30 min. Usage of supplementary anesthetics and rescue medications was noted.

Patients in Group A had lower HR after study drug administration (P < 0.001), before intubation (P < 0.001), at intubation (P < 0.001), and at various other time points. Group A had lower SBP (P = 0.049) and DBP (P = 0.005) after study drug administration. Fewer patients in Group A required additional propofol (14 vs. 27) (P < 0.001) and lesser doses (21.3 vs. 41.0 mg) (P = 0.008). Lesser Group A patients required additional fentanyl (15 vs. 21) (P = 0.114). More patients in Group A required ephedrine (P = 0.038). Use of phenylephrine and atropine was comparable in both groups.

Dexmedetomidine worked as an excellent adjuvant to anesthesia, providing good HR control and hemodynamic stability during DLT insertion and fiberoptic bronchoscopy confirmation. It decreases the overall anesthetic requirements and causes minimal side effects.