COMPARISON OF INTRAVENOUS FENTANYL VS. INTRAVENOUS DEXMEDETOMIDINE TO ATTENUATE EXTUBATION RESPONSE IN ADULT PATIENTS UNDERGOING GENERAL ANAESTHESIA- A PROSPECTIVE RANDOMIZED DOUBLE BLINDED CONTROLLED TRIAL.

Dr. L. Nageswara Rao, Dr. Haritha

Abstract


Introduction: Complications during and after extubation are more common than during tracheal intubation and induction of anaesthesia.
Hypertension and tachycardia are common events during extubation. Endotracheal extubation can be associated with arrhythmias, myocardial
ischemia and raised intracranial pressures due to sympathetic stimulation.
Aim: To compare the effects of dexmedetomidine and fentanyl on airway reflexes and hemodynamic responses during tracheal extubation in
patients undergoing surgeries under general anaesthesia.
Materials and Methods: 60 patients of either sex, ASA grade I -II normotensive, aged 20-60 years undergoing elective general surgeries under
general anaesthesia were randomized into 2 groups comprising of 30 patients each- Group D (dexmedetomidine group) and Group F (Fentanyl
Group). Anaesthetic technique was standardized. 15 min before the expected last surgical suture , patients received dexmedetomidine 0.75 μg/kg
IV over 10 minutes (dexmedetomidine group) or fentanyl 1 μg/kg IV over 10 minutes (fentanyl group). HR, SBP, DBP, RR and SPO2 were
recorded before, during and after extubation.
Results: Statistically significant lesser increase in HR, SBP, DBP, and RR were noted after extubation in the dexmedetomidine group than the
fentanyl group. Dexmedetomidine group had better extubation quality than the fentanyl group. Bradycardia in one case observed with
dexmedetomidine group than the fentanyl group but none required intervention.
Conclusion: Dexmedetomidine 0.75mcg/kg in 100 ml 0.9% normal saline administered 15 minutes before tracheal extubation was better
compared to Inj. Fentanyl 1 mcg/kg in 100 ml 0.9% normal saline in attenuating the extubation response with comparable adverse effects. Hence,
dexmedetomidine infusion can be a safer alternative to fentanyl infusion for attenuating extubation stress response.


Keywords


Dexmedetomidine, Fentanyl, Extubation, Hemodynamic Response.

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References


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