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Indian Journal of Anesthesia and Analgesia

Volume  6, Issue 2, MARCH-APRIL 2019, Pages 619-625
 

Original Article

Effect of Dexmedetomidine in Attenuating Hemodynamic Responses During Extubation

Olvyna D'souza1, Suman Sahu2

1Professor, Department of Anesthesia, MGM Medical College, Navi Mumbai, Maharashtra 410209, India. 2Senior Resident, Department of Cardiac Anesthesia, Eternal Heart Care Centre, Jaipur, Rajasthan 302017

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.6219.38

Abstract

Introduction: Tracheal extubation produces unfavourable hemodynamic alterations which may result in life threatening. The present study was aimed to assess the effect of injection dexmedetomidine 0.5 µg/kg for attenuation of hemodynamic responses and airway reflexes during extubation following surgery under general anaesthesia. Methodology: Patients of ASA grade I & II posted for surgery under general anesthesia were randomized to receive either dexmedetomedine 0.5 µg/kg body weight diluted to 20 ml in normal saline, over 10 minutes or normal saline 20 ml over 10 minutes. Hemodynamic parameters were recorded during infusion, at the time of reversal and after extubation. Extubation quality, time to eye opening and time to extubation were noted as well. Post extubation sedation was evaluated using Ramsay Sedation Scale and possible side effects during and after the administration of dexmedetomedine and during postoperative period were recorded. Results: We observed the mean heart rate and blood pressures to be significantly lower among patients in the dexmedetomedine group as compared to the control group. Mean time to extubation and eye opening was statistically and clinically significantly prolonged in the dexmedetomedine group as compared to the control group (p<0.01). 93% in the dexmedetomedine group had smooth extubation as against 57% in the control group. The incidence of hypertension and tachycardia was significantly higher among patients in the dexmedetomedine group as compared to the control group. Conclusions: Single bolus dose of dexmedetomidine 0.5 µg/kg administered as infusion over 10 minutes, before tracheal extubation attenuates hemodynamic responses effectively during extubation.

Introduction: Tracheal extubation produces unfavourable hemodynamic alterations which may result in life threatening. The present study was aimed to assess the effect of injection dexmedetomidine 0.5 µg/kg for attenuation of hemodynamic responses and airway reflexes during extubation following surgery under general anaesthesia. Methodology: Patients of ASA grade I & II posted for surgery under general anesthesia were randomized to receive either dexmedetomedine 0.5 µg/kg body weight diluted to 20 ml in normal saline, over 10 minutes or normal saline 20 ml over 10 minutes. Hemodynamic parameters were recorded during infusion, at the time of reversal and after extubation. Extubation quality, time to eye opening and time to extubation were noted as well. Post extubation sedation was evaluated using Ramsay Sedation Scale and possible side effects during and after the administration of dexmedetomedine and during postoperative period were recorded. Results: We observed the mean heart rate and blood pressures to be significantly lower among patients in the dexmedetomedine group as compared to the control group. Mean time to extubation and eye opening was statistically and clinically significantly prolonged in the dexmedetomedine group as compared to the control group (p<0.01). 93% in the dexmedetomedine group had smooth extubation as against 57% in the control group. The incidence of hypertension and tachycardia was significantly higher among patients in the dexmedetomedine group as compared to the control group. Conclusions: Single bolus dose of dexmedetomidine 0.5 µg/kg administered as infusion over 10 minutes, before tracheal extubation attenuates hemodynamic responses effectively during extubation.


Keywords : dexmedetomidine; extubation; preanesthetic dose.
Corresponding Author : Suman Sahu