Introduction: Tracheal extubation is almost always associated with hemodynamic changes due to reflex sympathetic discharge caused by epipharyngeal and laryngo-pharyngeal stimulation. This increase in
sympatho–adrenal activity may result in hypertension, tachycardia and arrhythmias.

Aims: The purpose of the study is to compare the effect of intravenous Fentanyl 1μg/kg with dexmedetomidine 0.7μg/kg on the hemodynamic and recovery responses during extubation.

Materials and methods: Prospective, randomized, double blind, controlled study was conducted in 60 patients of either sex between 20 and 50 yrs of age belonging to ASA-I and II, undergoing general procedures and urological procedures were selected for the
study.

Results: The heart rate increased in both the groups during extubation but the increase was more in Group-F patients. The MAP increased for the initial 1min after drug administration in Group-D. However,
dexmedetomidine attenuated the increase in blood pressure to a greater degree than lignocaine. The airway response (coughing) was better attenuated in Group-D than Group-F. The patients in Group-D were drowsy but responding to verbal commands when compared to Group-F.The incidence of bradycardia and hypotension though minimally present in Group-D, which was easily managed.

Conclusion: Compared to Fentanyl 1μg/ kg, dexmedetomidine 0.7μg/kg administered I.V. before extubation attenuates airway and hemodynamic reflexes to a greater extent allowing smooth and easy tracheal extubation, thereby providing comfortable recovery