Prospective Comparison of Pressor and Airway Responses to IV Esmolol and IV Dexmedetomidine during Emergence from General Anaesthesia and Extubation
Journal Title: Journal of Krishna Institute of Medical Sciences University - Year 2017, Vol 6, Issue 1
Abstract
Background: Tracheal extubation causes significant hemodynamic stimulation resulting in transient increase in blood pressure and heart rate. Aim and Objectives: To compare the efficacy of Esmolol and Dexmedetomidine given intravenously to attenuate the pressor and airway response to emergence from general anaesthesia and tracheal extubation. Materials and Methods: After obtaining institutional ethical committee approval and written informed consent, 90 ASA grade I and II patients, in the age group of 20-70 years, of either sex, undergoing elective surgery under general anaesthesia were included. At the end of surgery, patients received IV Esmolol 1.5 mg/kg (Group E) two minutes prior to extubation or IV Dexmedetomidine 0.5 mcg/kg (Group D) over ten minutes prior to extubation or no drug in the control group (Group C). Hemodynamic parameters were assessed before giving study drugs, before extubation and after extubation upto 15 minutes. Extubation quality was rated using 5 point cough grading. Sedation scoring was done using Modified Ramsay Sedation scale. Results: All hemodynamic parameters showed attenuation upto 15 minutes post extubation, in both Group E and Group D as compared to Group C. However, even though Injection Esmolol successfully controlled the hemodynamic response to extubation, the attenuation was more evident with Injection Dexmedetomidine, as the parameters were below the baseline values at all times after extubation, without excessive bradycardia or hypotension. None of the patients showed incidence of desaturation. The cough grading, and hence the quality of extubation, was better with Group D as compared to Group C and E. Patients in the Dexmedetomidine group, were significantly sedated as compared to Esmolol and Control group, but this aided a smooth extubation without any agitation. Conclusion: We conclude that IV Esmolol 1.5 mg/kg attenuates the pressor response, but IV Dexmedetomidine attenuates both pressor as well as the airway responses to extubation.
Authors and Affiliations
Malvika Prasad Tendulkar, Sanjot Sudhir Ninave
Keywords
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