Abhinaya Thagirisa1, Sherry Mathews2, Satyanarayana Nuthula3
BACKGROUND AND AIMS
Endotracheal extubation is one of the frequently performed procedures in the practice of anaesthesia. Endotracheal extubation is the translaryngeal removal of a tube from trachea via nose or mouth. Complications that occur during and after extubation are three times more common than that occurring during tracheal intubation and induction of anaesthesia. Hypertension and tachycardia are well documented events during extubation. Respiratory complications associated with tracheal extubation are coughing and sore throat (ranges from 38–96%), laryngospasm, bronchospasm which leads to hypoxemia. Laryngospasm is the commonest cause for postextubation upper airway obstruction. Dexmedetomidine is a highly selective α2 adrenoreceptor agonist (α2::α1 1620:1). α2 agonists decrease the sympathetic outflow and noradrenergic activity thereby counteracting hemodynamic fluctuations occurring at the time of extubation.1 Dexmedetomidine has been recently introduced in India, not many studies have been done using the same in order to obtund the extubation response. Hence this present study is conducted to see the effects of “dexmedetomidine (0.5 mcg/kg) on extubation response”.
MATERIALS AND METHODS
The first 50 cases presenting for surgery during the study period were included after satisfying the inclusion and exclusion criteria. After obtaining informed written consent, patients were randomly divided into 2 groups.
Group A: Dexmedetomidine: Received Dexmedetomidine infusion (25 patients).
Group B: Control Group: Received 0.9% sodium chloride as placebo (25 patients).
There was a significant difference in the HR, SBP, DBP, and MAP in both the groups. Group A receiving dexmedetomidine showed a statistically significant difference (P<0.05) in all the parameters from 5 mins. after starting administration of agent till 20 mins. after extubation.
Few adverse effects like bradycardia and hypotension were noted with group A compared to group B, but none of them required treatment. None of the patients in group A and group B had any other side effects like respiratory depression, laryngospasm, bronchospasm and undue sedation.
There was no significant difference in SpO2 between both the groups.
Based on our results, we concluded that administration of dexmedetomidine 0.5 mcg/kg infusion 15 mins. before extubation, stabilises hemodynamics and facilitates smooth extubation.