Attenuation of extubation responses: Comparison of prior treatment with verapamil and dexmedetomidine

Background: Tracheal extubation is almost always associated with stress response, airway response and arrhythmias. We have compared Verapamil and Dexmedetomidine on attenuation of these responses. Materials and Methods: Thirty patients (ASA grade I, II) scheduled for spinal surgeries under general anaesthesia were randomly divided into two groups. At the end of surgery, after return of spontaneous efforts (BIS > 80), in “Group V” Verapamil 0.1 mg/kg and in “Group D” Dexmedetomidine 0.3 μg/kg were administered bolus intravenously over one minute. Heart rate, SBP, DBP and MAP were recorded just before and 2 minutes after intravenous administration, just after oral suction and extubation and 10 minutes post-extubation. Duration of emergence and extubation, quality of extubation, Richmond Agitation and Sedation Score (RASS) and time to reach Modified Aldrit Score ≥ 9 were evaluated. Results: Heart Rate, SBP, DBP, MAP were higher in Group V than Group D but statistically insignificant (P > 0.05). Extubation Quality Scores was 1 for 20%, 2 for 60% and 3 for 20% patients in Group V whereas 1 in 80%, 2 in 20% in Group D. There was occurrence of Bradycardia within 2 minutes of administration of drug in 1 patient in Group D. RAAS score was in the range of –1 to + 1 in > 90% patient in Group V whereas –3 to –1 in 80% cases in Group D. Conclusion: Single dose of dexmedetomidine (0.3 μg/kg) given before extubation produced significant attenuation of circulatory and airway responses during extubation as compared to Verapamil (0.1 mg/kg).