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).

No conflict of interest has been declared by the author(s).

[Abstracts published in the Journal of Neuroanaesthesiology and Critical Care have not been reviewed by the Editorial Board of the Journal. These abstracts were presented at the annual meet of ISNACC and selected by the organizers and the scientific committee of the Society]