EFFECT OF DEXMEDETOMIDINE ON STRESS RESPONSE TO EXTUBATION

This study was undertaken to evaluate the efficacy of intravenous dexmedetomidine for attenuation of the stress response during extubation.60 patients who fulfilled the eligibility criteria were enrolled in the study and divided into two groups, GROUP D (Dexmedetomidine 1microgramkg) GROUP P (Normal saline). Drugs were administered 10 minutes before the administration of reversal agent. Blood pressure and pulse rate was monitored at 0, 3, 5, 10 minutes, after administration of reversal agent, after extubation, there after every 5minutes for 15 minutes. Degree of sedation was noted in the post extubation period. Pulse rate measured during various time intervals were all decreased in the dexmedetomidine group when compared to placebo group which was statistically significant (p lesser than0.05), except at 0 minute where the difference was insignificant ( p greater than 0.05). Mean Arterial Pressure measured during various time intervals were all decreased in the dexmedetomidine group when compared to placebo group which was statistically significant (p lesser than0.05), except at 0 minute and 3minutes where the difference was insignificant (p greater than 0.05). pulse rate and mean arterial pressure increased during extubation in both the groups but the difference in the amount of increase was significant, with the patients in the dexmedetomidine group showing less increase in pulse rate and mean arterial pressure. Patients in the dexmedetomidine group had sedation levels higher than placebo group (p lesser than0.05), at 5, 10 and15minutes, intervals after extubation. The highest score was 3.77 at 5 minutes post extubation and declined to 3.47 at 15 minutes post extubation. Dexmedetomidine given 10 minutes prior to planned reversal and extubation is effective in attenuating the stress response to extubation with minimal effects on recovery.