Efficacy of dexmedetomidine in attenuating hemodynamic and airway responses during extubation: a randomized double-blind study

Abstract

Introduction: Tracheal extubation causes significant hemodynamic changes and airway irritation. During smooth extubation there is an absence of straining, movement, coughing, breath holding, laryngospasm and minimal change in hemodynamic. Purpose of this study was to test the efficacy of dexmedetomidine in attenuating hemodynamic and airway responses during extubation.

Methods: Eighty ASA-PS I and II patients, receiving general anesthesia, were included in this randomized double-blinded study. Ten minutes before the end of anesthesia, Group D (Dexmedetomidine group) (n=40) received Inj. Dexmedetomidine 0.5mcg/kg and Group N (Normal Saline group) (n=40) received 10 ml normal saline over 10 mins. We recorded heart rate and mean arterial blood pressure prior to the drug administration till 10 mins after extubation. We also monitored the incidence of cough during extubation. Any possible side effects of study drugs were recorded.

Result: Age, gender, physical status, weight, duration of surgery, baseline heart rate and mean arterial pressure were comparable between the groups. There was a statistically significant difference (p < 0.05) in heart rate and mean arterial pressure between the groups after 5 mins of study drug administration and then throughout the study period. Using a four point scale for coughing during extubation, 10% of Group D and 50% of Group N had minimal cough, 22.5% of Group N and 2.5% of Group D had moderate cough.

Conclusion: Finding suggests that IV dexmedetomidine before extubation significantly attenuates hemodynamic and airway responses during extubation.