Study of the effects of dexmedetomidine on hemodynamic parameters and extubation quality in patients undergoing ENT surgery under general anaesthesia

Abstract

In ENT surgeries most of the cases are done under general anaesthesia and should be extubated smoothly. If a patient is lightly anesthetised, tracheal and laryngeal irritation can stimulate reflex responses during extubation like bucking, gagging, breath holding, laryngospasm, pulmonary oedema. Alpha 2-Adrenergic agonists are used for their sympatholytic, sedative, anaesthetic sparing and haemodynamic stabilizing properties. We aimed to study the extubation quality and hemodynamic parameters of dexmedetomidine undergoing ENT surgeries under general anaesthesia.This observational study included 100 patients undergoing ENT surgery under general anaesthesia, between 18 to 60yrs. Patients were divided into group P (n=50) and group PD (n=50). A standard general anaesthesia technique according to the Ent operation theatre protocol were followed for all patients. For maintenance group P received inj.Propofol 4mg/kg/hr and group PD received inj. Propofol 4mg/kg/hr and inj. Dexmedetomidine infusion 0.5ug/kg/hr as a standard protocol. Respective infusions were stopped at the start of skin closure. Heart rate, systolic blood pressure and diastolic blood pressure were recorded at the time of extubation and at 1,3,5. minutes till 30 minutes after extubation. Quality of extubation was evaluated using 5-point rating scale (extubation quality score) at extubation.The mean heart rate in the group P was 92/min while in the group PD was 75/min. The mean systolic blood pressure in the group P was 116mmhg while in the group PD was 108mmhg. The mean diastolic blood pressure in the group P was 85mmhg and 67mmhg in group PD (P<0.001). 11 patients of group p got extubation quality score of 2 while 41 cases of group PD got a score of 2(P<0.001).InjDexmedetomidine provides stable hemodynamic parameters during extubation and provides better extubation quality score.