Effect of dexmedetomidine on hemodynamic and recovery responses during tracheal extubation

Abstract

Endotracheal extubation is associated with cardiovascular and airway responses leading to tachycardia, hypertension, arrhythmias, myocardial ischemia, coughing, agitation, bronchospasm, increased bleeding, raised intracranial and intraocular pressure which may be life threatening especially in vulnerable patients. Dexmedetomidine, a highly selective α2-adrenoreceptor agonist is found to attenuate these effects and provide a smooth extubation. To assess the effect of dexmedetomidine on hemodynamic and ventilatory recovery during tracheal extubation. This comparative study was done in 42 patients who fulfilled the inclusion and exclusion criteria between the age group of 20 to 45 years from both sexes were randomly allocated in to two groups of 21 each. One group received 0.5mg Dexmedetomidine and the other group received 100 ml NS. Both groups were compared for the hemodynamic parameters at different time intervals during the whole procedure and were compared for differences if any. In the study group, parameters like Mean arterial pressure, Systolic Blood Pressure, Diastolic Blood Pressure and Heart Rate were under control than the control group. The extubation quality score between controls and dexmedetomidine group (2.14 vs. 1.24) is statistically significant (P<0.001). 14.28% of study group had cough compared to 52.39% in the control group. Bradycardia and Hypertension were significantly higher in the study population. Justbefore extubation, administration of dexmedetomidine ensures the smooth extubation of the trachea and reduces the cardiovascular responses. It also provides adequate sedation postoperatively.