The Comparison of the Effect of Dexmedetomidine and Lignocaine on Hemodynamic and Recovery Responses during Tracheal Extubation: A Prospective Randomized Double-Blind Comparative Study

Abstract Background: Attenuation of hemodynamic fluctuations and a smooth recovery are major goals in anesthesia practice, especially at the time of tracheal extubation. Dexmedetomidine, a selective α₂-adrenoceptor agonist, has been investigated for its ability to decrease sympathetic outflow and maintain hemodynamic stability at the time of emergence from anesthesia. Lignocaine, a commonly used local anesthetic, also possesses potential advantages in minimizing airway reflexes. The purpose of this study was to compare the hemodynamic and recovery responses of dexmedetomidine and lignocaine during tracheal extubation. Methods: Research investigators conducted a prospective randomized double-blinded study on 100 patients from among those requiring laparoscopic abdominal surgery with ASA I–II who were aged 20–45. Two separate groups consisting of n=50 patients received random distribution before study commenced. The subjects in Group D received a dexmedetomidine infusion at 0.75 μg/kg through 100 mL normal saline which continued for 15 minutes before extubation. The medical workers in Group L received a bolus injection of 1.5mg/kg lignocaine via intravenous route before performing extubation. Multiple measurements included heart rate and systolic/diastolic blood pressure along with mean arterial pressure among the studied patients. Researchers assessed both extubation success and emergence agitation together with recorded any adverse effects after surgery. Results: The two groups matched in all statistics about demographic characteristics. The administration of dexmedetomidine produced substantially lower heart rate as well as systolic blood pressure and diastolic blood pressure and mean arterial pressure after extubation compared to lignocaine administration (p < 0.001). Within the dexmedetomidine treatment group both extubation quality scores and emergence agitation scores were reduced while bradycardia incidence showed a minimal rise. The number of vomiting episodes was higher in the lignocaine group although they experienced fewer bradycardic incidents. Conclusion: Dexmedetomidine better suppressed the hemodynamic response and ensured better extubation quality and lower agitation scores than lignocaine, with a slightly higher incidence of bradycardia. Dexmedetomidine can be regarded as an effective choice in patients who need stable hemodynamics and smooth emergence