Effect of Clonidine and Dexmedetomidine on Haemodynamic and Recovery Responses During Tracheal Extubation: A Randomised DoubleBlind Comparative Study
Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2019, Vol 6, Issue 1
Abstract
Background and Aims: Emergence from anaesthesia and tracheal extubation are associated with transient surge in catecholamines due to sympathetic stimulation causing hypertension, tachycardia, myocardial ischaemia etc. Various drugs are being studied to attenuate the haemodynamic response to tracheal extubation. This study aimed to compare the effect of a bolus dose of different drugs of alpha 2 adrenergic agonists (clonidine and dexmedetomidine) on haemodynamic, airway reflexes and recovery responses during tracheal extubation. Materials and methods: ninety patients aged 20 to 45 Y of either sex of ASA gr I/II scheduled for elective surgical and gynaecological surgeries studied after randomisation into three groups. Technique of anaesthesia was standardised for all three groups. just 5 minutes before anticipated end of surgery Group A, Cand D received inj. Placebo (normal saline), Clonidine 0.75 µg/kg and Dexmedetomidine 0.5 µg/kg respectively intravenously over 2 min. Monitoring of heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP) and mean arterial blood pressure (MAP) were recorded at the time of bolus drug injection and there after 1,2 and 3 min after injection, during extubation, at 1, 3, 5, 10 and 15 min after extubation. Quality of extubation was evaluated immediately after extubation based on cough using five point rating score, postoperative sedation was evaluated on a six point scale. Side effects like laryngospasm, bronchospasm respiratory depression, desaturation, vomiting, hypotension, bradycardia and undue sedation were noted. Results: Haemodynamic parameters (HR, SBP, DBP and MAP) were significantly lower in study groups from 3 min of drug injection till the study period as compared to the placebo group. In majority of the cases the extubation quality score was 1 and 2 in study groups and score 3 in placebo group. Sedation scale was 2 and 3 group C and group D where as 2 in placebo group. Conclusion: Our study observes that alpha 2 adrenergic agonist are good and safe adjuvants to attenuate the stress response to emergence from anaesthesia and tracheal extubation. Dexmedetomidine behaved slightly better than clonidine to supress the haemodynamic response.
Authors and Affiliations
Sarada Devi Vankayalapati
Keywords
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- EP ID EP600514
- DOI 10.21088/ijaa.2349.8471.6119.13
- Views 65
- Downloads 0
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