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A study to assess the effects of intravenous dexmedetomidine and lignocaine on hemodynamic responses and airway reflexes during tracheal extubation in patients having laparoscopic surgery

Shankar Prasad Hatai, Manmohan Bagh.

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Introduction: The process of coming out of anaesthesia and tracheal extubation can cause hemodynamic reactions, and the sympathoadrenal response induces an increase in cardiac activity, which increases myocardial oxygen requirement and may be harmful as a result. To lessen airway and cardiovascular reactions, a variety of methods and medications have been suggested.
Aim: The purpose of this study is to investigate how Dexmedetomidine and Lignocaine affect airway reflexes and hemodynamic responses during tracheal extubation.
Method: The Department of Anaesthesia, SCB Medical College, Cuttack, Odisha conducted a double-blind, random study. 90 adult patients scheduled for laparoscopic surgery with ASA Grade I and Grade II between the ages of 19 and 50 were randomised. Prior to extubation, Group D got Dexmedetomidine 0.4 mcg/kg and Group L received Lidocaine 1.4 mg/kg, both medications having been diluted to 11 ml.
Result: Both groups experienced an increase in heart rate, which was noticeably higher in the Lignocaine group than the Dexmedetomidine group including during and following extubation (P-value of 0.002). Between the Dexmedetomidine group and the Lignocaine group, there was a significant difference in the mean arterial blood pressure from 2 minutes after extubation to 14 minutes after extubation. In comparison to the Dexmedetomidine group, the Lignocaine group experienced a greater increase in mean arterial blood pressure (P value 0.004). Dexmedetomidine considerably outperformed lignocaine in terms of extubation quality (as determined by the cough score; P-value 0.004).
Conclusion: Dexmedetomidine 0.4 mcg/kg attenuated the sympathetic response (HR, SBP) more effectively than Lignocaine 1.4 mg/kg both during and after extubation. Dexmedetomidine was used to help modulate the airway response, which allowed for a smooth tracheal extubation, a more uneventful recovery, and calmer patients in the post-operative recovery unit.

Key words: Dexmedetomidine, Lignocaine, Fentanyl, Propofol

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