Comparison of Dexmedetomidine Versus Esmolol in Attenuation of Sympathoadrenal Response to Tracheal Extubation After General Anaesthesia A Prospective Randomized Double Blind Study
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2018, Vol 6, Issue 1
Abstract
Emergence from general anesthesia and tracheal extubation is associated with increased catecholamine secretion, leading to tachycardia, hypertension and increases oxygen consumption for about 5-15 min postextubation. We investigated and compared the efficacy of dexmedetomidine and esmolol to attenuate airway and circulatory reflexes during emergence from general anesthesia and tracheal extubation. This prospective randomized double blind study was conducted at Dr Sampurnanda Medical College Hospital, Jodhpur, after obtaining institutional ethical committee approval and informed written consent, 102 patients of ASA Grade I-II aged 20-60 years received standard general anesthesia. At the closure of skin incision, patients were randomly allocated to receive either dexmedetomidine 0.7 µg/kg (Group D) or esmolol 1.5mg/kg (group E) or saline placebo (Group C) intravenously over 10 minutes in a double-blind design. Heart rate, systolic, diastolic and mean arterial pressures were assessed before, during- and after extubation. Time to eye opening and extubation time were recorded, also extubation and sedation scores were recorded, complications such as coughing, laryngospasm, bronchospasm and desaturation if any were also tabulated. Analysis revealed that Heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were comparable till 5 minutes of study drugs infusion(p>0.05) in all groups which became statistically highly significant at completion of study drugs infusion, during extubation(p<0.001) and remained significantly higher till 30 minutes postextubation. Time to extubation and eye opening were prolonged in Group D. Incidence of coughing & Agitation was more in Group C.In dexmedetomidine group patients were more sedated post extubation. Extubation quality was better in dexmedetomidine group than esmolol and control. We concluded that single dose of dexmedetomidine 0.7μg/kg body weight given over 10 minutes before extubation is better than esmolol(1.5mg/kg) in attenuating the hemodynamic and airway reflexes during emergence from anesthesia without causing undue sedation, but may prolong time to extubation and eye opening.
Authors and Affiliations
R. K. Solanki, Naveen Paliwal, Dokne Chintey, Vandana Sharma, Chanda Khatri
Keywords
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