Effect of dexmedetomidine on hemodynamic responses during tracheal extubation

Introduction and Aims: Dexmedetomidine, an ?-2-adrenoreceptor agonist, offers excellent sedation without significant effect on respiratory or cardiovascular stability. It may be, thus, helpful to achieve smooth extubation. This study was conducted to assess the efficacy of dexmedetomidine in attenuating hemodynamic responses and airway reflexes encountered during extubation. Materials and Methods: Sixty ASA I & II patients, aged 18-50 years, undergoing elective surgery under general endotracheal anesthesia were enrolled for the study. They were assigned to two groups-1 and 2, of 30 patients each, in a randomized, double blind manner, to receive dexmedetomidine or normal saline (NS) intravenous infusion, respectively. Hemodynamic parameters (heart rate, systolic, diastolic and mean arterial pressures) were recorded at the time of starting the study drug infusion, during the infusion, at extubation and thereafter at specific intervals for 30 minutes. Quality of extubation was assessed on a 5-point scale; postoperative sedation assessed by Ramsay Sedation Scale. Any untoward occurrence like undue sedation, vomiting, hypotension, respiratory depression, laryngospasm, bronchospasm and desaturation was noted. Results: Heart rate, systolic, diastolic and mean arterial pressures were significantly higher in Group 2 (p < 0> Conclusion: Dexmedetomidine 0.5 mcg/kg infusion given over 10 minutes prior to extubation, decreases hemodynamic responses and results in smooth extubation