COMPARING DEXMEDETOMIDINE AND LIGNOCAINE IN ATTENUATING HEMODYNAMIC RESPONSE DURING AND FOLLOWING TRACHEAL EXTUBATION IN PATIENTS UNDERGOING SURGERIES UNDER GENERAL ANESTHESIA

DR MEENA SINGH

Volume : IX, Issue : VIII, August - 2019

COMPARING DEXMEDETOMIDINE AND LIGNOCAINE IN ATTENUATING HEMODYNAMIC RESPONSE DURING AND FOLLOWING TRACHEAL EXTUBATION IN PATIENTS UNDERGOING SURGERIES UNDER GENERAL ANESTHESIA

Dr Meena Singh

Abstract :

Background: Emergence from general anesthesia and extubation is a period of intense physiological stress for all the patients. In our study, we compared dexmedetomidine with lignocaine to blunt stress response induced during and following extubation and providing a smooth transition from extubation phase to recovery. Material and Methods: 75 patients were electively planned for surgeries under general anesthesia aged 18–50years of ASA Grades I and II, were randomly divided into 3 groups (Group N, D, L), each of 25 patients depending on pretreatment with study drug. Group N received, 10 ml of Normal saline(NS), Group D received Injection Dexmedetomidine 0.5 µgkg–1 of bwt diluted in normal saline to prepare 10ml drug solution and Group L received Injection Lignocaine 1.5 mgkg–1 of bwt diluted in NS to prepare 10ml of study drug. All three drugs were given 5min before extubation over 60 sec. HR, SBP,DBP were recorded just before (D0) and 1, 3, 5 (D1,D3,D5) min after the study drug administration, at extubation (E) and 1, 3, 5, 10, 15 min after extubation (E1,E3,E5, E10 and E15). Quality of extubation was recorded with four point scale. After extubation all these patients were also observed for sedation by Ramsey sedation score. Result: All groups showed a statistically significant increase in HR, SBP and DBP during (E) and immediately after extubation (E1) (P < 0.05). This rise was less in Group D as compared to other two groups. Sedation score was higher (Grade 3) in D group as compare with L and N group where there was no sedation post–extubation was found. Extubation quality score of the majority of patients was 1 in Group D and found better than other two groups. Conclusion: Single bolus dose of IV dexmedetomidine 0.5 µg/kg given before tracheal extubation effectively attenuates hemodynamic response to extubation as compared to 1.5 mg/kg lignocaine.