Abstract
Background
 Tracheal extubation causes significant hemodynamic changes and airway irritation. During smooth extubation there is absence of straining, movement, coughing, breath holding, laryngospasm and minimal change in hemodynamic. Purpose of this study was to evaluate the efficacy of dexmedetomidine in attenuating hemodynamic and airway responses during extubation.
 Methodology
 Eighty patients receiving general anesthesia were included in this randomized double-blind study. Ten minutes before the end of anesthesia, Group D (Dexmedetomidine group) (n=40) received Inj. Dexmedetomidine 0.5mcg/kg and Group N (Normal Saline group) (n=40) received 10 ml normal saline over 10 mins. Heart rate and mean arterial pressure were recorded prior to the drug administration till 10 mins after extubation. The incidence of cough was monitored during extubation. Any possible side effects of study drugs were recorded.
 
 
 Results
 Age, gender, physical status, weight, duration of surgery, baseline heart rate and mean arterial pressure were comparable between the groups. There was statistically significant difference (p < 0.05) in heart rate and mean arterial pressure between the groups after 5 mins of study drug administration and then throughout the study period. Using four point scale for coughing during extubation, 10% of Group D and 50% of Group N had minimal cough, 22.5% of Group N and 2.5% of Group D had moderate cough. 
 Conclusion
 Finding suggests that intravenous dexmedetomidine before extubation significantly attenuates hemodynamic and airway responses during extubation.
Highlights
Age, gender, physical status, weight, duration of surgery, baseline heart rate and mean arterial pressure were comparable between the groups
Finding suggests that intravenous dexmedetomidine before extubation significantly attenuates hemodynamic and airway responses during extubation
Tracheal extubation is the discontinuation of an artificial airway when the indications for its placement like general anaesthesia, airway obstruction, protection of airway, suctioning, ventilatory failure and hypoxemia no longer exist
Summary
Tracheal extubation is the discontinuation of an artificial airway when the indications for its placement like general anaesthesia, airway obstruction, protection of airway, suctioning, ventilatory failure and hypoxemia no longer exist. Airway irritation during tracheal extubation may cause cough or difficulty in breathing which contributes change in hemodynamics.[5,6,7] The majority of patients are able to tolerate those responses without any significant consequences. Tracheal extubation causes significant hemodynamic changes and airway irritation. During smooth extubation there is absence of straining, movement, coughing, breath holding, laryngospasm and minimal change in hemodynamic. Purpose of this study was to evaluate the efficacy of dexmedetomidine in attenuating hemodynamic and airway responses during extubation. Heart rate and mean arterial pressure were recorded prior to the drug administration till 10 mins after extubation.
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