Publication:

The effectiveness of intravenous dexmedetomidine on haemodynamic responses during tracheal extubation in patients undergoing craniotomies

Background Dexmedetomidine an α2 agonist reduces heart rate and blood pressure due to sympatholytic activity. The aim of this study was to evaluate the effect of dexmedetomidine on haemodynamic response during endotracheal extubation in patients undergoing craniotomies for intracranial space occupying lesion (ICSOL).

Methods Sixty patients of ASA grade I and II, age 18-50 years scheduled for craniotomy for nonvascular ICSOL were selected after randomization into 2 groups with 30 patients in each group. Group D and C received an IV infusion of dexmedetomidine 0.5 mg/kg and normal saline 100 ml respectively over 10 min at the time of skin closure in a double-blind manner. Heart rate, systolic and diastolic blood pressure were recorded just before drug administration, 3 and 5 minutes after drug administration, during extubation and at 3, 5, 10 and 15 minutes after extubation. Respiratory rate and oxygen saturation were analyzed at 3, 5, 10 and15 minutes after extubation. Any laryngospasm, bronchospasm, desaturation, respiratory depression, vomiting, hypotension and bradycardia was noted.

Results Heart rate, systolic and diastolic blood pressure increased during emergence time in both groups (p<0.05) but this increase was more significant in control group than group D. SBP and heart rate were significantly lower in group D from 3 minutes after drug administration to 15 minutes after extubation. DBP was lower in group D during extubation till 15 minutes after extubation (p<0.01). No significant differences were observed in the respect of adverse events between the groups.

Conclusions Intravenous dexmedetomidine 0.5 mg/kg before extubation is attenuates haemodynamic response during endotracheal extubation in craniotomies.