Comparison of Dexmedetomidine as an Adjuvant to Propofol and Propofol as a Sole Agent in Induction of General Anaesthesia: A Randomised Clinical Trial

Abstract

Introduction: Agents used for induction of anaesthesia often cause vasodilation and suppression of the sympathetic nervous system, leading to a drop in blood pressure. Additionally, laryngoscopy and endotracheal intubation can cause hypertension and tachycardia. So, maintaining haemodynamic stability during induction, intubation and maintenance of anaesthesia is important. Induction of anaesthesia needs sufficient depth of anaesthesia while preventing haemodynamic derangement. Aim: To study the haemodynamic effects of dexmedetomidine when used as an adjuvant to propofol as compared to propofol as a sole agent in the induction of General Anaesthesia (GA) in patients undergoing elective surgeries under GA. Materials and Methods: This double-blinded randomised clinical study was conducted at the Department of Anaesthesiology, SUT Academy of Medical Sciences, Trivandrum, Kerala, India, from October 2025 to April 2026. A total of 38 patients were enrolled and randomly assigned to two groups. Group A patients were induced with propofol and vecuronium as muscle relaxants, and in Group B patients were initially given dexmedetomidine before induction with propofol and vecuronium. Heart Rate (HR), Non Invasive Blood Pressure (NIBP) Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) and Oxygen Saturation (SpO2 ) were recorded in each group at pre op, before induction, one minute, five minutes, 10 minutes and 15 minutes post induction. An Independent t-test was used to compare quantitative parameters, Chi-square test for categorical variables and a Mann-Whitney U Test for comparing ordinal parameters. Results: A total of 38 patients assessed showed no significant demographic differences. Post induction tachycardia (group A-91.11±5.78; group B-79.00±13.25) was significant in group A. There was significant hypotension (MAP, DBP) post induction in group A {MAP 5 min post induction (group A-84.1±11.0, group B-93.1±9.6), DBP 5 min post induction (group A-70.6±9.8; group B-77.8±10)}. Group A required a significantly higher mean dose of propofol (134.2±25.2 mg) compared to group B (101.1±18.8 mg). Conclusion: Dexmedetomidine as an adjuvant to propofol provides better haemodynamic stability than propofol alone during induction of GA. The total propofol requirement is also significantly lower in the patients when induced along with Dexmedetomidine.