BACKGROUND:Tracheal extubation and emergence is associated with significant haemodynamic alterations and is poorly tolerated by patients with co-morbid conditions. We compared the efficacy of fentanyl and dexmedetomidine in mitigating haemodynamic stress response and assessed extubation quality in study groups. MATERIALS AND METHODS: One fifty patients of either sex, ASA grade I & II normotensive patients, aged 18-55 years undergoing elective surgeries under general anaesthesia were randomized into 3 equal groups. Anaesthetic technique was standardized. 10 minutes prior to extubation, patients in Group N, F and D received intravenous bolus infusion of 0.9% normal Saline, Fentanyl 1μg /kg and Dexmedetomidine 1μg /kg respectively over 10 minutes period. Heart Rate (HR), Systolic BP (SBP), Diastolic BP (DBP) and Mean Arterial Pressure (MAP) were noted at extubation, 2, 4, 6, 8, 10 min and at regular interval thereafter for a period of two hours. Extubation quality was evaluated on 5-point extubation quality scale [ scale 1 = no coughing, 2 = smooth extubation, minimal coughing (1 or 2 times), 3 = moderate coughing (3 or 4 times), 4 = severe coughing (5-10 times) and straining, 5 = poor extubation, very uncomfortable (laryngospasm and coughing >10 times)]. Ramsay sedation score and Aldrete's recovery score were recorded. Any adverse events, use of rescue drugs and postoperative analgesics were noted.
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