Effect of Intravenous Dexmedetomidine on Haemodynamic and Recovery Response During Tracheal Extubation

Abstract

BACKGROUND Dexmedetomidine, a highly selective alpha-2 agonist, has various beneficial effects like sedation, analgesia, attenuation of stress response with minimal cardiovascular instability or respiratory depression and may be a useful agent to facilitate smooth tracheal extubation.The aim of this study is to observe the effects of intravenous infusion of Dexmedetomidine in attenuating adverse haemodynamic and recovery response associated with tracheal extubation in patients operated under General Anaesthesia. METHODS AND MATERIALS120 patients were divided into two groups with 60 cases in each group by matching patient's age, sex, Mallampati and ASA grading and randomised with a sealed envelope and divided into two equal groups of 60 each namely group D and group C. Group D and C received an intravenous infusion of dexmedetomidine 0.75 mcg/kg or placebo respectively, over 15 minutes before anticipated time of end of surgery, Anaesthesia techniques were standardised. Heart rate, systolic, diastolic, mean arterial pressures were recorded while starting injection; at 1, 3, 5, 10, 15 minutes after starting injection; at the time of giving reversal; during extubation; at 1, 3, 5 minutes after extubation; and thereafter every 5 minutes for 15 minutes. Quality of extubation was evaluated on a 5-point scale and postoperative sedation on a 6-point scale. Any event of laryngospasm, bronchospasm, desaturation, respiratory depression, vomiting, hypotension, undue sedation was noted. Statistical Analysis-Descriptive data presented as Mean ± SD and in percentage. Pair wise comparison between the groups was done by Student's unpaired t-test. For Qualitative data, Chi-square test was used. Fisher's exact test was used to determine p-value of frequency of complication. P-value<0.05 is considered significant. RESULTSHeart rate, systolic, diastolic, mean arterial pressures were significantly higher in group C (P <0.05). Extubation quality score of majority of patients was 2 in group D and 3 in group C. Sedation score of most patients was 3 in group D and 2 in group C. Bradycardia was higher in group D. One patient in group D, two patients in group C had vomiting. CONCLUSIONDexmedetomidine 0.75 mcg/kg administered 15 minutes before extubation stabilises haemodynamics and facilitates smooth extubation. KEYWORDSAlpha-2-agonist, Dexmedetomidine, Extubation, Haemodynamics.HOW TO CITE THIS ARTICLE: Dutta G, Das N. Effect of intravenous dexmedetomidine on haemodynamic and recovery response during tracheal extubation.