A randomized controlled study comparing dexmedetomidine and lignocaine for attenuation of hemodynamic and recovery responses to extubation in laparoscopic abdominal surgery Dexmedetomidine vs Lignocaine for Extubation
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Abstract
Background & Aims:
Tracheal extubation is frequently associated with significant hemodynamic oscillations and airway reflex responses. This study aimed to compare the efficacy of dexmedetomidine and lignocaine in attenuating these responses in patients undergoing laparoscopic abdominal surgery.
Material & Methods:
This prospective, randomized study included 178 adult patients of ASA physical status I and II scheduled for elective laparoscopic abdominal surgery. Patients were randomly allocated using sealed envelopes to receive either intravenous dexmedetomidine 0.75 µg/kg in 100 ml normal saline over 15 minutes before the end of surgery (n=89) or intravenous lignocaine 2% 1.5 mg/kg as a bolus 2 minutes before extubation (n=89). Standard general anesthesia was administered to all patients. Heart rate, systolic, diastolic, and mean arterial pressure were recorded at baseline, during drug administration, at extubation, and for 30 minutes post-extubation. Extubation quality, emergence agitation, and adverse events were also assessed.
Results:
The increase in HR, SBP, DBP, and MAP from baseline was significantly lower in Group D compared to Group L at extubation and at all time points for 30 minutes thereafter (p<0.05). A significantly higher proportion of patients in Group D had better (lower) extubation quality scores (p<0.001) and lower emergence agitation scores (p=0.002) compared to Group L. Bradycardia (HR<60/min) was more frequent in Group D (12.4% vs. 4.5%, p=0.059), but none required treatment.
Conclusion:
Intravenous dexmedetomidine administered prior to tracheal extubation is more effective than lignocaine in maintaining hemodynamic stability, providing smooth extubation, and ensuring a better quality of recovery in patients undergoing laparoscopic abdominal surgeries.
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References
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