Intravenous dexmedetomidine (0.5�g/kg) versus intravenous esmolol (1.5mg/kg) given before extubation: Hemodynamic changes

Abstract

Dexmedetomidine does not appear to have any direct effects on the heart. A biphasic cardiovascular response has been described after the application of dexmedetomidine. The administration of a bolus of 1 µg/kg body weight, initially results in a transient increase of the blood pressure and a reflex decrease in heart rate, especially in young healthy patients. The initial reaction can be explained by the peripheral alpha 2B adrenoceptors stimulation of vascular smooth muscles and “can be attenuated by a slow infusion over 10 or more minutes”. The study population (90 patients) was randomly divided into three groups with 30 patients in each group using computer generated random numbers and was placed in sealed envelopes containing the name of the group and patient was asked to pick up the envelope. The envelope was opened by senior anaesthesiologist who was assigned to prepare the solutions and was not involved with the study. Basal mean arterial pressures were comparable between the groups and was statistically insignificant (p=0.22). The changes in MAP were similar to that of SBP. Insignificant rise in MAP was observed during extubation in group D and Group E whereas the rise was highly significant in group C and reached pre extubation values only after 15 mins.