Comparative Evaluation of Dexmedetomidine and Magnesium Sulphate in Mitigating Pressor Response while Extubation in Patients undergoing Mastoidectomies

Abstract

Background: Ear surgeries performed under general anaesthesia mandate smooth emergence after surgery to facilitate a good surgical outcome. We conducted this study with primary objective of comparing dexmedetomidine and magnesium sulfate (MgSO4) in attenuating extubation response after mastoid surgeries. The secondary outcome was to study the adverse effects if any.
 Methods: Sixty patients of ASA grade I and II, aged 18 -50 yrs were randomized into 2 groups of 30 each receiving either dexmedetomidine 0.5μg/kg or MgSO4 30 mg/kg respectively 10 minutes prior to completion of surgery. Efficacy of both drugs in attenuating cough reflex, PONV, shivering and fluctuations in haemodynamic response were recorded. Postoperative sedation was noted. Any laryngospasm, bronchospasm, hypotension, bradycardia, desaturation was also noted.
 Statistical analysis: The observations were recorded and analysed using statistics calculator SPSS 19.00 version. Student’s t test and χ2 (chi square) test were used to analyze quantitative and qualitative data respectively. P-value<0.05 was considered statistically significant.
 Results: The variations in systolic, diastolic blood pressure and heart rate were significantly less with dexmedetomidine as compared to MgSO4 (p<0.01). Incidence of coughing (p=0.002), PONV(p=0.002), was less with dexmedetomidine while shivering control was similar in both groups, the sedation was more with dexmedetomidine (p=0.004). Patients with dexmedetomidine infusion were more satisfied in terms of reduced nausea sensation, drowsiness.
 Conclusion: Dexmedetomidine provides a smoother recovery profile as compared to MgSO4 when administered prior to extubation improving the surgical outcome and patient satisfaction in patients undergoing mastoidectomies.