Laryngoscopy and intubation are painful stimuli ,that results in adverse physiological outcomes,like tachycrdia ,hypertension,arrythmiaa,pulmonary edema.

The main objective of study is to blunt the autonomic response of laryngoscopy and intubation.

Title of the study :To evaluate the effect of dexmedetimedine nebulization upon blunting autonomic response of laryngoscopy and intubation in patients undergoing elective intubation.

It is randomized control trial,sample size was calculated by using openEpi sample size calculator By using SBPafter 1 min of laeyngoscopy in decmedetomedine versus group were 113.2+_14.503and 125.92+_15.263 respectively,power 95 percent and confidence 95 percent ,The required sample size for the study is 72( 36 ) in each group.

After taking informed consent patients are randomly divided into two groups via opaque sealed envelop technique.Half of envelops will be labelled as letter D ,and half will be labelled as letter C .Patients in group D will be nebulized with dexmedetomedine with dose of 1ug/kg made total volume of 5 ml with normal saline.While group C will be nebulized with 5 ml of 0.9 percent normal saline 30 min prior to elective intubation.Hemodynamic parmmeters heart rate ,systolic bp,diastolic bp,MAP will be noted at baseline and 0,1,5,10 min after inrubation

Inclusion criteria:

Age 18-65 years ASAI-III Both genders Patients undergoing elective intubation

Exclusion criteria:

Patients with renal hepatic or neurological disease Bleeding diathesis Mallampatti III-IV Previous histoey of difficult intubation.