EFFECT OF DEXMEDETOMIDINE ON STRESS RESPONSE TO EXTUBATION

Abstract

This study was undertaken to evaluate the efficacy of
intravenous dexmedetomidine for attenuation of the stress
response during extubation.60 patients who fulfilled the
eligibility criteria were enrolled in the study and divided into
two groups, GROUP D (Dexmedetomidine 1microgramkg)
GROUP P (Normal saline). Drugs were administered 10 minutes
before the administration of reversal agent. Blood
pressure and pulse rate was monitored at 0, 3, 5, 10 minutes,
after administration of reversal agent, after extubation, there
after every 5minutes for 15 minutes. Degree of sedation was
noted in the post extubation period. Pulse rate measured
during various time intervals were all decreased in the
dexmedetomidine group when compared to placebo group
which was statistically significant (p lesser than0.05), except
at 0 minute where the difference was insignificant ( p greater
than 0.05). Mean Arterial Pressure measured during various
time intervals were all decreased in the dexmedetomidine
group when compared to placebo group which was
statistically significant (p lesser than0.05), except at 0 minute
and 3minutes where the difference was insignificant (p
greater than 0.05). pulse rate and mean arterial pressure
increased during extubation in both the groups but the
difference in the amount of increase was significant, with the
patients in the dexmedetomidine group showing less increase
in pulse rate and mean arterial pressure. Patients in the
dexmedetomidine group had sedation levels higher than
placebo group (p lesser than0.05), at 5, 10 and15minutes,
intervals after extubation. The highest score was 3.77 at 5
minutes post extubation and declined to 3.47 at 15 minutes
post extubation. Dexmedetomidine given 10 minutes prior to
planned reversal and extubation is effective in attenuating the
stress response to extubation with minimal effects on
recovery.
Keyword :dexmedetomidine, extubation stress response
attenuation