EFFECT OF DEXMEDETOMIDINE ON HAEMODYNAMICS DURING EXTUBATION IN PATIENTS UNDERGOING MASTOID TYMPANOPLASTY PROCEDURE THROUGH PROSPECTIVE OBSERVATIONAL STUDY
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2018, Vol 7, Issue 51
Abstract
BACKGROUND Dexmedetomidine an α2 agonist has been successfully used for attenuating the stress response to laryngoscopy. It is known to produce sedation, anxiolysis, hypnosis, analgesia, and sympatholysis. Thus it can reduce the requirement of inhalational agents and narcotics when used as an adjunct to general anaesthesia thereby providing smooth extubation since patient will be awake pain free and without respiratory compromise. Our objective is to study the effect of Dexmedetomidine on haemodynamics during extubation in patients undergoing mastoid-tympanoplasty procedure compared to control group through prospective observational study. MATERIALS AND METHODS After obtaining Institutional Ethics Committee approval, 60 ASA I –II patients undergoing Mastoid -Tympanoplasty procedure were randomly enrolled into the study. After intubation and before surgical incision, Dexmedetomidine infusion was started at the rate of 0.4 mcg/kg/hr., which was continued until after extubation. Intra-op monitoring consisted of ECG, non-invasive blood pressure, oxygen saturation, ETCO2; from pre-induction to post- extubation for 15 minutes. Post-op monitoring consisted of ECG, respiratory rate, NIBP, sedation score, any side effects to Dexmedetomidine. Requirement of any beta-blocker/ionotropic agents/ vasoconstrictors or vasodilators/ total IV fluids given was recorded. Postoperatively patient was followed up for 2-3 hrs for any adverse effect of study drug/postoperative complications/haemodynamic stability. Same method of anaesthetic management and monitoring was followed in patients not receiving Dexmedetomidine and peri extubation response was watched for. Data was collected and analysed using standard statistical principles. RESULTS Haemodynamic stability was more with Dexmedetomidine group during peri-extubation period as compared to pre-op values than control group. Both surgeon and patient satisfaction and comfort were better with Dexmedetomidine than control group because of bloodless field under microscope during surgery and sedative anxiolytic analgesic properties of Dexmedetomidine postoperatively respectively. CONCLUSION Dexmedetomidine at the dose studied is safe with hypotensive effect and is an alternative to traditional beta blockers for surgical procedures. Infusion of Dexmedetomidine without a loading dose appears to be adequate in maintaining haemodynamic stability without any extra sedation effect.
Authors and Affiliations
Vijaya Gaware, Biju Sekhar, Rekha S, Geetha George
Keywords
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- EP ID EP550477
- DOI 10.14260/jemds/2018/1207
- Views 58
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