What is it about?
Comparing the Effects of Fentanyl and Dexmedetomidine for Attenuation of the Haemodynamic Response
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Why is it important?
Introduction: Tracheal extubation is almost always associated with hemodynamic changes due to reflex sympathetic discharge caused by epipharyngeal and laryngo-pharyngeal stimulation. This increase in sympatho–adrenal activity may result in hypertension, tachycardia and arrhythmias. Aims: The purpose of the study is to compare the effect of intravenous Fentanyl 1μg/kg with dexmedetomidine 0.7μg/kg on the hemodynamic and recovery responses during extubation. Materials and methods: Prospective, randomized, double blind, controlled study was conducted in 60 patients of either sex between 20 and 50 yrs of age belonging to ASA-I and II, undergoing general procedures and urological procedures were selected for the study. Results: The heart rate increased in both the groups during extubation but the increase was more in Group-F patients. The MAP increased for the initial 1min after drug administration in Group-D. However, dexmedetomidine attenuated the increase in blood pressure to a greater degree than lignocaine. The airway response (coughing) was better attenuated in Group-D than Group-F. The patients in Group-D were drowsy but responding to verbal commands when compared to Group-F.The incidence of bradycardia and hypotension though minimally present in Group-D, which was easily managed. Conclusion: Compared to Fentanyl 1μg/ kg, dexmedetomidine 0.7μg/kg administered I.V. before extubation attenuates airway and hemodynamic reflexes to a greater extent allowing smooth and easy tracheal extubation, thereby providing comfortable recovery
Perspectives
Introduction: Tracheal extubation is almost always associated with hemodynamic changes due to reflex sympathetic discharge caused by epipharyngeal and laryngo-pharyngeal stimulation. This increase in sympatho–adrenal activity may result in hypertension, tachycardia and arrhythmias. Aims: The purpose of the study is to compare the effect of intravenous Fentanyl 1μg/kg with dexmedetomidine 0.7μg/kg on the hemodynamic and recovery responses during extubation. Materials and methods: Prospective, randomized, double blind, controlled study was conducted in 60 patients of either sex between 20 and 50 yrs of age belonging to ASA-I and II, undergoing general procedures and urological procedures were selected for the study. Results: The heart rate increased in both the groups during extubation but the increase was more in Group-F patients. The MAP increased for the initial 1min after drug administration in Group-D. However, dexmedetomidine attenuated the increase in blood pressure to a greater degree than lignocaine. The airway response (coughing) was better attenuated in Group-D than Group-F. The patients in Group-D were drowsy but responding to verbal commands when compared to Group-F.The incidence of bradycardia and hypotension though minimally present in Group-D, which was easily managed. Conclusion: Compared to Fentanyl 1μg/ kg, dexmedetomidine 0.7μg/kg administered I.V. before extubation attenuates airway and hemodynamic reflexes to a greater extent allowing smooth and easy tracheal extubation, thereby providing comfortable recovery
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This page is a summary of: Study Comparing the Effects of Fentanyl and Dexmedetomidine for Attenuation of the Haemodynamic Response During Endotrcheal Extubation in Patients Undergoing Elective Surgeries, Indian Journal of Anaesthesia and Analgesia, June 2020, Red Flower Publication Private, Ltd.,
DOI: 10.21088/ijaa.2349.8471.7320.4.
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