Comparison of Dexmedetomidine and Magnesium Sulphate in Attenuating Airway and Hemodynamic Response during Extubation in Patients Undergoing Craniotomies - A Randomised Clinical Trial

BACKGROUND: Intracranial neurosurgeries require cardiovascular stability during extubation period. Hence this study was done to compare the effect of dexmedetomidine and magnesium sulphate in attenuation of hemodynamic and airway responses during extubation in patients undergoing craniotomies. AIMandOBJECTIVE: To compare the efficacy of I.V Dexmedetomidine versus I.V Magnesium sulphate in evaluation of hemodynamic and airway response in patients undergoing craniotomies. METHODS AND MATERIAL: Total 60 patients with ASA Grade 1 and2 aged 18 to 50 years undergoing craniotomies under general anaesthesia were randomly divided into two groups, with each group of 30 patients. Group D: received an infusion of dexmedetomidine 0.5mcg/kg over a period of 10 minutes at the time of skin closure. Group M: received an infusion of magnesium sulphate 30mg/kg over a period of 10 minutes at the time of skin closure. Hemodynamic parameters such as heart rate, systolic and diastolic blood pressure were recorded just before drug administration,3 and 5 minutes after drug administration, during extubation and 3, 5,10 and 15 minutes after extubation. Respiratory rate, oxygen saturation were analysed at 3,5,10 and 15 minutes after extubation. Extubation quality rated on a 5 point scale and postoperative sedation on Ramsay sedation scale.Any laryngospasm, bronchospasm, desaturation, respiratory depression, vomiting, hypotension, bradycardia were noted. RESULTS: Hemodynamic responses was significantly lower in group D compared to group M. There were no significant differences in the prevalence of adverse events among the two groups. CONCLUSION: Dexmedetomidine 0.5mcg/kg is more effective than Magnesium sulphate 30mg/kg in controlling hemodynamic and airway reflexes during endotracheal extubation in craniotomy. KEY WORDS: Dexmedetomidine, Magnesium sulphate, airway, haemodynamic reflexes, extubation , craniotomies.