Comparing different doses of dexmedetomidine in attenuating extubation response in chronic smokers undergoing total extraperitoneal laparoscopic inguinal hernia repair: a randomized prospective study

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Abstract

Background
During the process of emergence from general anesthesia, tracheal extubation is a very critical step. Tracheal extubation is not just a reversal of intubation, as during extubation we encounter a change of state from controlled conditions to an uncontrolled environment. We have aimed our study at evaluating the attenuating effect on the extubation response using three different doses of dexmedetomidine on patients who are smokers and undergoing total extraperitoneal laparoscopic inguinal hernia repair under general anesthesia. This randomized, controlled, triple-blinded study included 90 smokers aged between 40 and 60 years. These patients were randomized to receive dexmedetomidine 0.5 μg/kg (group A), 0.75 μg/kg (group B), and 1 μg/kg (group C) prepared as a 10 ml infusion started 10 min before patients were extubated. Extubation quality, hemodynamic changes, oxygen saturation, sedation, and postoperative complications were evaluated.
Results
The extubation quality became better, sedation and incidence of bradycardia in the post-operative period increased with a higher dose of dexmedetomidine. Attenuation of hemodynamic parameters was observed after 4 min of starting infusion and during extubation in each group and was found to be significant ( < 0.001).
Conclusions
It was concluded that dexmedetomidine when used at a dose of 0.75 μg/kg provided excellent extubation conditions with stable hemodynamic parameters in chronic smokers with minimal sedation and no other adverse effects.

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