Abstract
THE EFFECT OF DEXMEDETOMIDINE ON HEMODYNAMIC AND RECOVERY RESPONSES DURING TRACHEAL EXTUBATION IN PATIENTS UNDERGOING ELECTIVE GENERAL SURGICAL AND UROLOGICAL PROCEDURES

Rohey Jan, Malik, Zaffer Iqbal, Velayet Nabi Bucch, Farooq Ahmad Ganie*, Showkat Negroo, Waseem Mohmad and Aabid Hussain Mir

ABSTRACT

Aims: To study the effects of dexmedetomidine in attenuating the hemodynamic response to extubation and emergence from anaesthesia. To study effect on the quality of extubation, postoperative sedation and any side effects. Settings and Design: Prospective, randomized, double‑blind study. Subjects and Methods: 80 patients of either sex between 20 and 50 years of age belonging to ASA-I and II, undergoing general surgical procedures and urological procedures were selected for the study .Patients were randomly allocated to two equal groups of 40 each to receive either dexmedetomidine 0.75 microgram/kg (Group A) or Normal Saline (Group B) over a period of 10 minutes, 10 minutes prior to anticipated extubation. Heart rate, systolic blood pressure, diastolic blood pressure, SpO2 was recorded at base line and at the start of drug injection, at 1, 5, 8 and 10 minutes after the start of drug infusion and thereafter at the time of extubation and at 1, 3 and 5 minutes after extubation, followed by every 5 minutes for 30 minutes. Quality of extubation was evaluated based on cough immediately after extubation using 5 point rating scale (extubation quality score). Post-operative sedation was evaluated on a Ramsay sedation scale (6 point scale) at extubation and thereafter at every 15 minutes for 1 hour. Occurrence of any event like laryngospasm, bronchospasm, desaturation, respiratory depression, vomiting was noted. Results: Heart rate, systolic, diastolic, mean arterial pressures were significantly higher in group B (P < 0.05). Extubation quality score of majority of patients was superior in group A than in group B. Sedation score of most patients was 3 in group A and 2 in group B. Bradycardia and hypotension incidences were higher in group A. The incidence of adverse effects was statistically insignificant between the two groups (p valve>0.05). No patient had any other side effects. Conclusion: Dexmedetomidine 0.75 microgram per kg intravenous infusion administered over a period of 10 minutes, just prior to extubation was effective in attenuating the haemodynamic stress response during tracheal extubation with minimal adverse effects.

Keywords: dexmedetomidine, extubation, hemodynamics.


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