An interventional study of Group D (Dexmedetomidine) and Group L (Lignocaine) in Lignocaine, Hypertensive Patients and Dexmedetomidine, sponsored by Tanta University. Completed at 1 site in Egypt. Open to participants aged 45 Years to 70 Years. Per ClinicalTrials.gov, last updated 2026-10-27.
Sponsored by Tanta University · Not applicable, Interventional, and Prevention
This study aims to compare the efficacy of preoperative nebulized lignocaine versus nebulized dexmedetomidine for blunting the pressor response to laryngoscopy and intubation in patients with controlled hypertension under medical treatment.
Securing the airway through endotracheal intubation is a fundamental responsibility of the anesthesiologist during general anesthesia. Direct laryngoscopy followed by intubation induces a stress response leading to hemodynamic changes, which are often transient, unpredictable, and variable .This response usually lasts for 30 seconds to 10 minutes The mechanisms underlying the hemodynamic responses are not completely understood, although they have been attributed to a reflex sympathetic discharge caused by stimulation of the upper respiratory tract .This pressor response is characterized by rapid increase in heart rate and blood pressure, potentially leading to arrhythmias and some other adverse events .
These effects are generally well tolerated by overall healthy patients but can be lethal to patients with pre-existing conditions such as coronary artery disease, hypertension , preeclampsia, and cerebrovascular pathologies such as tumors, aneurysms, or increased intracranial pressure .
Hypertensive patients are particularly vulnerable to these effects due to their pre-existing cardiovascular conditions. The pressor response is triggered by sympathetic stimulation during laryngoscopy, causing an average increase in blood pressure by 40-50% and heart rate by 20% . These changes, while often well-tolerated in healthy individuals, could be greater risk to those with hypertension, coronary artery disease .
To mitigate these adverse effects, various pharmacological agents have been explored. Among them, lignocaine, a widely used local anesthetic, has shown efficacy for attenuating the hemodynamic response to laryngoscopy and intubation . Nebulized lignocaine, in particular, offers a non-invasive method of administration with fewer side effects compared to intravenous delivery. On the other hand, dexmedetomidine, a selective alpha-2 adrenergic agonist, is gaining attention for its sedative, analgesic, and sympatholytic properties . Current studies suggest that nebulized dexmedetomidine may offer significant hemodynamic stability with fewer side effects than intravenous administration, making it a promising alternative, especially in hypertensive patients .
The choice of agent to blunt the pressor response in hypertensive patients is an important aspect of preoperative management, as minimizing cardiovascular strain during surgery can improve patient outcomes. Although numerous pharmacological agents have been studied, the ideal drug for preoperative use remains controversial.
In particular, the use of nebulized medications offers the advantage of targeted local delivery to the upper respiratory tract, which may result in more effective control of the sympathetic response with fewer systemic side effects. Both lignocaine and dexmedetomidine have shown promise in preliminary studies, yet comparative research specifically targeting controlled hypertensive patients remains limited.
This study aims to compare the efficacy of preoperative nebulized lignocaine versus nebulized dexmedetomidine for blunting the pressor response to laryngoscopy and intubation in patients with controlled hypertension under medical treatment.
Tanta University is the lead sponsor of 1,010 studies on the registry; 321 are open to participants now.
Of its 15 completed or terminated interventional studies of FDA-regulated products, 0 (0%) have results posted.
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Exclusion Criteria:
Underlined terms in the criteria open these too. Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
ASA physical status
The anaesthetists’ scale of health before surgery: I is healthy, II has a mild illness that is under control, III a severe one, IV a severe illness that is a constant threat to life. V and VI are used for the critically ill and for organ donors.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
COPD
Chronic obstructive pulmonary disease: long-term lung disease that makes it hard to breathe out, including emphysema and chronic bronchitis.
Explained by clinicaltrials.gg, not part of the registry record. The study team decides who can take part.
Group D (Dexmedetomidine): 25 patients will undergo nebulization with dexmedetomidine (1 μg/kg), mixed with normal saline to a total volume of 5 mL, administered via a nebulizer face mask at a continuous flow of 6 L/min of 100% oxygen over 10 minutes before the beginning of anesthesia.
Drug: Group D (Dexmedetomidine)
Group L (Lignocaine): 25 patients will undergo nebulization with 2% lignocaine (1.5 mg/kg) according to ideal body weight maximum 100 mg, mixed with normal saline to a total volume of 5 mL, administered via a nebulizer face mask at a continuous flow of 6 L/min of 100% oxygen over 10 minutes before the beginning of anesthesia.
Drug: Group L (Lignocaine)
Group D (Dexmedetomidine): 25 patients will undergo nebulization with dexmedetomidine (1 μg/kg), mixed with normal saline to a total volume of 5 mL, administered via a nebulizer face mask at a continuous flow of 6 L/min of 100% oxygen over 10 minutes before the beginning of anesthesia.
Group L (Lignocaine): 25 patients will undergo nebulization with 2% lignocaine (1.5 mg/kg) according to ideal body weight maximum 100 mg, mixed with normal saline to a total volume of 5 mL, administered via a nebulizer face mask at a continuous flow of 6 L/min of 100% oxygen over 10 minutes before the beginning of anesthesia.
Assessment of blunting Pressor Response to Laryngoscopy
Time frame: 10 minutes post nebulization
Assessment of Heart rate change
Time frame: 10 minutes post-intubation
Plan to share: Yes — it will be available if it needed
Supporting information: Study protocol, Statistical analysis plan, Informed consent form
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From the registry record's own update history. This site started tracking changes on Sep 25, 2026; for anything earlier, see the record history on ClinicalTrials.gov ↗
This study is completed, as verified in Dec 2025. You cannot join it, but the record below documents what was studied.
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Studies of the drugs tested here: Dexmedetomidine · Lidocaine