Dexmedetomidine premedication as an adjuvant to fentanyl in patients undergoing elective surgeries under general anaesthesia

Abstract

Aims and Objectives: Alpha-2 agonists are being increasingly used as adjuvants in general anaesthesia. The present study was carried out to evaluate the ability of intravenous Dexmedetomidine as premedicant in decreasing intraoperative dose of opiods, anaesthetics and for attenuation of haemodynamic responses during laryngoscopy, tracheal intubation, surgery and extubation. Methods: Hundred patients scheduled for elective general surgery were randomized into 2 groups, D & F [n=50 in each group] Group F: Received Fentanyl 2 mcg/kg. Group D: Received Dexmedetomidine 1 mcg/kg IV over 20 minutes plus fentanyl 2mcg/kg IV 3 minutes before induction. Maintenance infusion of Dexmedetomidine 0.4mcg/kg/hr was given. Discussion: The sedative, analgesia and anxiolytic effects of Dexmedetomidine are attributed to its stimulation of alpha2A subtype in CNS. Results: The pressor responses were effectively decreased by Dexmedetomidine and were highly significant on comparison. The mean dose of opioids & anaesthetics were also decreased significantly by Dexmedetomideine. Conclusion: Dexmedetomidine is an excellent drug as it not only decreases the magnitude of haemodynamic responses to intubation, surgery & extubation, but also decreases the dose of opioids & anaesthetics in achieving adequate analgesia & anaesthesia respectively.