Comparison of Dexmedetomidine and Magnesium Sulphate in Attenuation of Airway and Pressor Responses during Extubation in Patients Undergoing Craniotomies
Journal Title: International Journal of Contemporary Medical Research - Year 2017, Vol 4, Issue 5
Abstract
Introduction: The anaesthatic technique for intracranial neurosurgery must provide cardiovascular stability during extubation period. This study was conducted to compare the effect of dexmedetomidine and magnesium sulphate in attenuation of haemodynamic and airway responses during endotracheal extubation in patients undergoing craniotomies for intracranial space occupying lesion (ICSOL). Material and Methods: Ninety patients of ASA grade I and II, age 18 -50 yrs scheduled for craniotomy for nonvascular ICSOL were studied after randomization into 3 groups with 30 patients in each group. Group D, M and C received an IV infusion of dexmedetomidine 0.5μg/kg, magnesium sulphate 30 mg/kg and normal saline 100 ml respectively over 10 min at the time of skin closure in a double blind manner. Heart rate, systolic and diastolic blood pressure were recorded just before drug administration, 3 and 5 min after drug administration, during extubation and at 3, 5, 10 and 15 minutes after extubation. Respiratory rate, oxygen saturation were analyzed at 3, 5, 10 and15 min 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 was noted. Results: Heart rate, systolic and diastolic blood pressure increased during emergence time in all the three groups but these parameters were significantly lower in group D than group C (p<0.01) and M (p<0.05) and significantly lower in group M than group C. Twenty seven patients had extubation score 1 in group D as compared to 19 and 18 patients in group c and m respectively (p<0.05). Sedation score of most patients was 3 in group D and 1 in group m and c (p<0.01). There were no significant differences in the prevalence of adverse events among the 3 groups. Conclusion: Dexmedetomidine 0.5μg/kg is more effective than magnesium sulfate 30 mg/kg in controlling haemodynamic and airway reflexes during endotracheal extubation in craniotomy.
Authors and Affiliations
Neelima Tandon, Shikha Goyal
Keywords
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