A comparison of nebulised lidocaine versus dexmedetomidine for attenuation of hemodynamic response to laryngoscopy and tracheal intubation.

Direct laryngoscopy and tracheal intubation following induction of anaesthesia are associated with hemodynamic changes due to increased sympatho-adrenal activity, which may result in increase in heart rate and blood pressure. This rise in blood pressure and heart rate is transient and variable. This response is likely to be tolerated by healthy patients but can be exaggerated in susceptible individuals and may precipitate hypertensive crises, myocardial ischemia, arrhythmias, or increases in intracranial pressure.

Lidocaine is a local anaesthetic and class 1B antiarrhythmic drug which can provide topical analgesia by blocking nerve conduction and diminish airway reflex. Nebulised Lidocaine(2%)  administered in doses of 2mg/kg is found to be effective to attenuate hemodynamic response after laryngoscopy and tracheal intubation.

Dexmedetomidine is a potent and highly selective alpha-2 receptor agonist with sympatholytic, sedative, amnestic and analgesic properties. Nebulised dexmedetomidine administered in doses of 1µg/kg is found to be an effective premedication to attenuate hemodynamic response after laryngoscopy and tracheal intubation**.**

This study is designed to compare the effect of nebulised Lidocaine versus Dexmedetomidine for attenuation of  hemodynamic response to laryngoscopy and tracheal intubation**.**