Effect of dexmedetomidine on hemodynamic and recovery responses during tracheal extubationc

Abstract

Background: The α2 adrenoreceptor agonist, Dexmedetomidine, provides excellent sedation with minimal cardiovascular instability or respiratory depression and may be a useful adjunct to facilitate smooth tracheal extubation. Materials and methods: We retrospectively analyzed the data of patients who underwent elective general surgical and ENT procedures, fifty patients were included in this study, patients who received an intravenous infusion of dexmedetomidine (group A) 0.4mcg/kg in 100ml NS over 15 min were compared to those who didn’t receive dexmedetomidine (group B). Heart rate, systolic, diastolic, and mean arterial pressures were recorded while starting injection, at 1, 3, 5, 10, 15 minutes after starting injection, during extubation, at 1, 3, 5 minutes after extubation, and thereafter every 5 minutes for 30 minutes were collected and Quality of extubation which was evaluated on a 5-point scale and postoperative sedation on a 6-point scale were collected and analyzed. Any event of laryngospasm, bronchospasm, desaturation, respiratory depression, vomiting, hypotension, and undue sedation was noted from the data. Results: Heart rate, systolic, diastolic, and mean arterial pressures were significantly higher in group B (P < 0.05). The extubation quality score of the majority of patients was 2 in group A and 3 in group B. Sedation score of most patients was 3 in group A and 2 in group B. Bradycardia and hypotension incidences were higher in group B. One patient in group A and two patients in group B had vomiting. No patient had any other side effects. Conclusion: Dexmedetomidine 0.4 mcg/kg administered 15 minutes before extubation had been found to stabilize hemodynamics and facilitate smooth extubation and increase postoperative sedation.