title: Attenuation of circulatory and airway responses to endotracheal extubation in craniotomies for intracerebral space occupying lesions: Dexmedetomidine versus lignocaine.
abstract: OBJECTIVE
  The objective of the study is to compare the effect of dexmedetomidine versus lignocaine in attenuation of circulatory and airway responses during endotracheal extubation in craniotomies for intracerebral space occupying lesions (ICSOL).
  
  
  METHODS
  A total of 50 patients of American Society of Anesthesiologists Grade I and II of either sex, aged 18-50 years undergoing craniotomies for non-vascular ICSOL under general anesthesia were divided into two groups according to drug received. Group D (n = 25) received dexmedetomidine (0.5 mcg/kg) whereas group L (n = 25) received lignocaine (1.5 mg/kg). Both the drugs were given 5 min before the extubation over a period of 60 s. Values for heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), were recorded just before (A0) and 1, 3, 5 (A1, A3, A5) min after the study drug administration, at extubation (E) and 1, 3, 5, 10, 15 min after extubation (E1, E3, E5, E10 and E15). Respiratory rate, oxygen saturation and airway responses like coughing, breath-holding, laryngospasm/bronchospasm were recorded only at extubation (E) and 1, 3, 5, 10, 15 min after extubation (E1, E3, E5, E10, E15). Quality of extubation was recorded with four point scale. After extubation all these patients were also observed for sedation by Ramsey sedation score.
  
  
  RESULTS
  Both groups showed a statistically significant increase (D < L) in HR, SBP and DBP during (E) and immediately after extubation (E1) (P < 0.05). Dexmedetomidine (72%) produced a higher degree of sedation (Grade 3) as compare with lignocaine (0%) and with no incidence of coughing or breath holding (P < 0.05).
  
  
  CONCLUSIONS
  Single dose of dexmedetomidine (0.5 mcg/kg) given 5 min before extubation produced significant attenuation of circulatory and airway responses produced during extubation as compared to Lignocaine (1.5 mg/kg) in ICSOL.
authors.affiliation: Department of Anaesthesiology, G.R. Medical College, Gwalior, Madhya Pradesh, India.
authors.forename: Dilip
authors.initials: D
authors.lastname: Kothari
authors.affiliation: Department of Anaesthesiology, G.R. Medical College, Gwalior, Madhya Pradesh, India.
authors.forename: Neelima
authors.initials: N
authors.lastname: Tandon
authors.affiliation: Department of Anaesthesiology, Safdarjang Hospital, New Delhi, India.
authors.forename: Meena
authors.initials: M
authors.lastname: Singh
authors.affiliation: Department of Anaesthesiology, G.R. Medical College, Gwalior, Madhya Pradesh, India.
authors.forename: Arun
authors.initials: A
authors.lastname: Kumar
keywords: Airway; circulatory reflexes; dexmedetomidine; extubation; lignocaine