To compare the effects of intravenous dexmedetomidine and lignocaine on hemodynamic responses and airway reflexes during tracheal extubation in patients undergoing laparoscopic surgeries

Introduction :Emergence from anaesthesia and tracheal extubation can be associated with hemodynamic responses and sympatho-adrenal response results in increased cardiac workload leading to rise in myocardial oxygen demand and may be detrimental subsequently. Many techniques and drugs have been proposed to attenuate airway and cardiovascular responses. Aims: This study intends to compare the effect of Dexmedetomidine and Lignocaine on haemodynamic responses and airway reflexes during tracheal extubation. Materials and Methods: A double-blind, randomized study was conducted in the Department of Anaesthesiology 100 adult patients of age group 18 to 60 years of ASA Grade I and Grade II scheduled for laparoscopic surgery were studied in randomized manner. Group D received Dexmedetomidine 0.5mcg/kg and Group L received Lidocaine 1.5 mg/kg, both drugs diluted to 10ml and administered intravenously as bolus over 60 seconds prior to extubation. Results : Increase in heart rate was observed in both groups and it was significantly higher in Lignocaine group than Dexmedetomidine group, during extubation as well as after extubation (P-value of 0.001). We observed that the mean arterial blood pressure varied significantly between Dexmedetomidine group and Lignocaine group starting from 1 min after extubation up to 15 mins after extubation. Mean arterial blood pressure rise was more with Lignocaine group as compared to Dexmedetomidine group (P-value < 0.005). The quality of extubation (measured by cough score) was significantly better in Dexmedetomidine group compared to Lignocaine group (P-value <0.005). Conclusion : The attenuation of sympathetic response (HR, SBP) was better with Dexmedetomidine 0.5 mcg/kg than Lignocaine 1.5 mg/kg at the time of extubation and in the period following extubation. The airway response was better controlled with the use of Dexmedetomidine allowing a smooth tracheal extubation, thereby providing a more uneventful recovery and calm patients in post-operative recovery unit