Efficacy of two doses of dexmedetomidine on attenuating cardiovascular response and safety of respiratory tract to extubation.

Introduction: Extubation can be associated with an adverse hemodynamic or respiratory response, which may be serious in cardiovascular written or in the elderly. The present study was conducted with the aim of investigating the effect of two different doses of dexmedetomidine in the prevention of extubation complications.

Methods: This randomized clinical trial was conducted in Isfahan in 2020-2021 on 174 patients undergoing elective surgery. Patients were randomly divided into 3 groups receiving dexmedetomidine 1 μg/kg (D1), dexmedetomidine 0.5 μg/kg (D2), and normal saline (S). Hemodynamic variables include heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), mean arterial pressure (MAP), and peripheral blood oxygen saturation (Spo2) was measured and recorded before removing the endotracheal tube and at 1, 3, 5 and 10 minutes after extubation. Also, airway responses to extubation such as cough, hoarseness, and laryngospasm were investigated.

Results: SBP, MAP, and HR in the D1 group were significantly lower than in other groups. In the D2 group, these measurements were lower than the control group at 3, 5, and 10 minutes after extubation (P<0.05 for all). In placebo group, SBP, MAP, and HR increased significantly after extubation (P=0.01). In group D1, cough (P=0.007) and its intensity (P=0.013), nausea and vomiting (P=0.04) and chills (P=0.001) were less than in other groups.

Conclusion: In the D1 group, attenuation of autonomic response to extubation was more than other groups and side effects were less than D2 group, and in both groups, these side effects were less than the saline group.