A comparison of effects of dexmedetomidine versus fentanyl on airway reflexes and haemodynamic responses to tracheal extubation during nasal surgeries: A double blind randomized study

Abstract

Aims: Comparison of the effects of Dexmedetomidine versus fentanyl on airway reflexes and haemodynamic responses to tracheal extubation during nasal surgeries.Materials & methods: 60 patients of either sex, aged 18-60 years of ASA grade I or II scheduled for elective nasal surgeries under general anaesthesia were analyzed. The patients were randomly divided into 2 groups (Group D & Group F) of 30 each (Group D received Dexmedetomidine & Group F received Fentanyl). Pre-anaesthetic check up was done one day before surgery in every patient. Cardiovascular parameters were recorded during preoxygenation (T1), after 5min of induction (T2), after 20 minutes of induction (T3), after every 10mins interval intra operative till 60 minutes after induction (T4,T5,T6) and 10,5 and 1minute before extubation (E10,E5,E1). Postoperative sedation was assessed on a six-point scale (Ramsay scale). Modified Aldrete scoring was recorded every 15 minutes for first 1 hour. A score of nine or more points was required for eligibility to discharge from the recovery room.Results: There was a significant difference between the groups with respect to extubation quality. The prevalence of no coughing was significantly higher in patients in the Dexmedetomidine group compared with those in the fentanyl group. No significant difference was found in sedation scores and modified aldrete scores between group D and group F.Conclusion: Dexmedetomidine administered before tracheal extubation, was more effective in maintaining the haemodynamic stability, facilitated smooth tracheal extubation and had a better quality of recovery as compared to fentanyl.