A Randomized Comparative Study between Dexmedetomidine and Fentanyl on Attenuating Stress Response and Airway Response to Tracheal Extubation

Background: Tracheal extubation and emergence is associated with major hemodynamic alterations and is poorly tolerated by patients of comorbid disorders. The efficacy of dexmedetomidine and fentanyl was contrasted in mitigating hemodynamic stress response in study groups and evaluated the quality of extubation. Aim and Objectives: To study the efficacy of dexmedetomidine and fentanyl on the attenuation of hemodynamic responses and airway reflexes during extubation following surgery under general anaesthesia. Material and Methods: A randomized comparative study was conducted in Shri B. M. Patil Medical College Hospital and Research Centre, Vijayapura. Total of 60 patients scheduled for various surgical procedures under general anaesthesia were allotted into two groups. Group D: Intravenous dexmedetomidine 0.4mcg/kg body weight. Group F: Intravenous fentanyl 0.5 mcg/kg body weight. Results: Peak rise in mean heart rate was 86.7 % in Group D and 117.5% in Group F, Peak rise in systolic blood pressure was 150.3% in Group F and 109.8% in Group D, peak rise in mean arterial blood pressure was 115.7% in Group F and 88.2% in Group D and diastolic blood pressure rise was 98.9% in Group F and 78.2% in Group D respectively. Dexmedetomidine group had better extubation quality than the fentanyl group. Conclusion: Intravenous injection of dexmedetomidine administered 15 minutes before tracheal extubation was better as compared to intravenous injection of fentanyl in attenuating airway and hemodynamic reflexes to a greater extent allowing smooth and easy tracheal extubation, thus providing comfortable recovery.