Comparison of dexmedetomidine with ETT/Ambu-LMA exchange for smooth emergence in tympanoplasty surgery: a randomized prospective study

Abstract

Background and Aim: Exchange of the endotracheal tube (ETT) with laryngeal mask airway (LMA) before emergence from anaesthesia and use of dexmedetomidine due to its anxiolytic, analgesic qualities and less respiratory depressant effects , reduced the complications during extubation with better surgical outcome especially in otolaryngology surgeries. Aim of this randomized-prospective study is to compare the effectiveness of ETT/ ambu laryngeal mask ALMA) exchange and dexmedetomidine for smooth extubation in patients undergoing elective tympanoplasty. Methods and Materials: 60 patients undergoing elective tympanoplasty under general anaesthesia were randomly divided into two groups- 30 patients in each group. Group I: ALMA (ambu laryngeal mask airway) used for ETT/LM exchange Group II: Dexmedetomidine 1.0 mcg/kg given 10 minutes before the end of surgery. Results: In group I patients 28 pateints and 27 patients in group II had smooth extubation. All cases in Group I and Group II maintained a regular respiratory pattern during the study without desaturation and maintaining adequate tidal volume. There was insignificant difference in hemodyamic parameter between the groups. Conclusion: ETT/ALMA exchange and dexmedetomidine 1.0 ?g/kg along with sevoflurane produced smooth emergence in patients undergoing elective tympanoplasty surgery. Keywords: Ambu laryngeal mask airway(AMLA), Endotracheal tube (ETT), Dexmedetomidine, Smooth extubation, Postoperative nausea vomiting(PONV)