Methods: Fifty ASA grades I/II patients, aged 14–65 years scheduled for elective surgery were divided randomly into two equal groups (n=25). In the study group dexmedetomidine was infused at the rate of 0.5 µg/kg/hr and control group received normal saline during the study period. The study period was from the start of dural closure to the closure of skin incision. The hemodynamic changes, emergence characteristics and complications during the study period were recorded.

Results: Heart rate and mean arterial pressure were significantly lower in dexmedetomidin group as compared to control group (p<0.05) at the time extubation and up to 10 minutes after extubation. Blunting of tachycardia response and the hypertensive response to extubation were observed in these patients. Statistically significant (p< 0.05) difference is found in emergence agitation, bucking, coughing and shivering in between the two groups. The time to eye opening and time for extubation were less in study group compared to control group but not statistically significant.

Conclusions: Dexmedetomidine attenuates stress responses to various noxious stimuli at the time of extubation, maintains haemodynamic stability, and blunts tachycardia and hypertensive response. At the same time it also reduces the emergence reactions to extutbation in patients undergoing supratentorial craniotomy