Background Hemodynamic fluctuations, including increased heart rate and blood pressure, during intubation are common and can be detrimental, particularly in patients with cardiovascular conditions. Dexmedetomidine, an alpha-2 adrenergic agonist, is known to mitigate such responses by reducing sympathetic activation. While intranasal administration of dexmedetomidine is effective, it may cause local irritation. Nebulized dexmedetomidine may offer a better alternative for premedication without these adverse effects. This study aims to evaluate the effect of nebulized dexmedetomidine on hemodynamic responses during laryngoscopy and intubation. Methods A randomized controlled trial was conducted on patients undergoing general anesthesia. Participants were divided into two groups: Group ND (nebulized dexmedetomidine 10 minutes prior to surgery) and Group NS (nebulized saline as control). After preoxygenation and fentanyl administration, anesthesia was induced with propofol and vecuronium. Hemodynamic parameters-heart rate, systolic, diastolic, and mean blood pressures-were recorded during induction, just before laryngoscopy, immediately post-intubation, and at 1, 3, and 5 minutes post-intubation. Postoperative pain scores were assessed 30 minutes after extubation. Results Both groups had similar demographic data. Group ND showed a slight decrease in heart rate after nebulized dexmedetomidine, with a significant reduction during laryngoscopy and 1 minute post-intubation (P < 0.0001 and P = 0.006, respectively). Systolic blood pressure was significantly lower in Group ND compared to Group NS at multiple time points (P < 0.05). There were no adverse effects reported with nebulized dexmedetomidine. Conclusion Nebulized dexmedetomidine effectively blunts hemodynamic responses to laryngoscopy and intubation, offering a safe and effective premedication strategy with no adverse effects.

Nebulized Dexmedetomidine, Hemodynamic Response, Intubation, Laryngoscopy, Premedication, Anesthesia.