Study of hemodynamic and airway reflexes during emergence from general anaesthesia and tracheal extubation with and without using dexmedetomidine in patients undergoing laparoscopic cholecystectomy

Authors

Keywords:

Dexmedetomidine, Emergence, Extubation

Abstract

Introduction: The emergence phase and tracheal extubation are critical due to potential hemodynamic changes and airway reflexes. This study aimed to evaluate Dexmedetomidine's effectiveness in mitigating these responses during extubation.

Methods: Forty-eight ASA Physical Status I and II patients, aged 18-60, undergoing elective laparoscopic cholecystectomy were enrolled at Shree Birendra Hospital, Kathmandu, Nepal, with Institutional Review Committee approval. Group D (n=24) received 0.25 mcg/kg Dexmedetomidine in 100 ml saline, while Group N (n=24) received 100 ml saline over 10 minutes at the end of surgery. Heart rate and mean arterial pressure (MAP) were recorded at baseline, 3, 5, and 10 minutes post-administration, during extubation, and at 1, 3, 5, and 10 minutes post-extubation. Extubation smoothness was rated on a 5-point scale. Statistical analysis included Fisher's Exact test, chi-square test, Mann-Whitney test, independent t-test, and repeated measures ANOVA (RM ANOVA). A p-value of <0.05 was considered significant.

Results: Demographic profiles and ASA-PS statuses were similar between groups. Group D had a lower heart rate compared to Group N at 10 minutes post-administration and showed more stable heart rate changes around extubation. Significant differences in heart rate were observed at 10 minutes post-administration, during extubation, and at 1, 3, 5, and 10 minutes post-extubation. Group N had higher MAP levels during and after extubation. Extubation smoothness was better in Group D, with 54.17% achieving a score of 1 versus 4.17% in Group N.

Conclusion: Dexmedetomidine effectively reduces hemodynamic reflexes and facilitates smoother extubation.

           

Author Biographies

Gaurav KC, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal

Resident, Department of Anaesthesiology

Bishwo Ram Amatya, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal

Associate Professor, Department of Anaesthesiology

Sachhyatkar Bista, Nepalese Army Institute of Health Sciences, Kathmandu, Nepal

Assistant Professor, Department of Anaesthesiology

https://doi.org/10.3126/jpahs.v11i2.71690

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Published

2024-12-05

How to Cite

KC, G., Amatya, B. R., & Bista, S. (2024). Study of hemodynamic and airway reflexes during emergence from general anaesthesia and tracheal extubation with and without using dexmedetomidine in patients undergoing laparoscopic cholecystectomy. Journal of Patan Academy of Health Sciences, 11(2), 44–50. Retrieved from https://www.jpahs.edu.np/index.php/jpahs/article/view/393