Comparison between dexmedetomidine and 2% lidocaine administration on rate pressure product and perfusion index during endotracheal intubation: a double–blind randomized controlled trial

Abstract

Background: Endotracheal intubation performed with laryngoscopy can trigger significant hemodynamic responses such as increased blood pressure, heart rate, and catecholamine levels. The administration of dexmedetomidine and 2% lidocaine has been shown to attenuate these hemodynamic responses during intubation. This study aims to compare the effects of intravenous dexmedetomidine and 2% lidocaine on rate pressure product (RPP) and perfusion index (IP) in patients undergoing endotracheal intubation.

Methodology: This double-blind randomized controlled trial was conducted on 46 patients who underwent intubation at Dr. Moewardi General Hospital and met the inclusion and exclusion criteria. Participants were divided into two groups: one group received dexmedetomidine 1 mcg/kg in 20 mL saline infusion over 6 minutes at the time of induction and the other group received 2% lidocaine 1.5 mg/kg bolus over 90 seconds. Hemodynamic parameters, including systolic blood pressure, heart rate, RPP, and IP, were measured before, immediately after intubation, and at 3 and 5 minutes post-intubation.

Results: There were no significant differences between the dexmedetomidine 1 mcg/kg group and the 2% lidocaine 1.5 mg/kg bolus group in terms of RPP (P = 0.11) and IP (P = 0.06). Both drugs demonstrated significant differences in values at the time points before induction, after intubation, and at 3 and 5 minutes post-intubation.

Conclusion: Dexmedetomidine is not more effective than 2% lidocaine in reducing the rate pressure product and perfusion index (IP) during endotracheal intubation

Abbreviations: BMI: Body Mass Index, DBP: Diastolic Blood Pressure, IP: perfusion index, RPP: rate pressure product,  SBP: Systolic Blood Pressure

Keywords: dexmedetomidine; heart rate; Hemodynamic; intubation; lidocaine; perfusion index; rate pressure product

Citation: Dewi FH, Swastikasari DS, Arianto AT, Purnomo HD, Santoso SB. Comparison between dexmedetomidine and 2% lidocaine administration on rate pressure product and perfusion index during endotracheal intubation: a double–blind randomized controlled trial. Anaesth. pain intensive care 2026;30(1):101-107. DOI: 10.35975/apic.v30i1.3109

Received: May 09, 2025; Revised: October 26, 2024; Accepted: January 01, 2025