Effectiveness of dexmedetomidine as an adjuvant on hemodynamic parameters and recovery profile of patients undergoing sitting position intracranial tumour surgeries with desflurane as maintenance agent: A randomized prospective comparative double blinded study

Author(s): Srilaxmi Rao1, Deepa Shriyan1, Kedar Mahajan1
1Department of Anaesthesiology, T.N.M.C and BYL Nair Ch. Hospital, Clinical Trials Registry, India.
Copyright © Srilaxmi Rao, Deepa Shriyan, Kedar Mahajan. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Background: We aimed to study the influence of low dose dexmedetomidine as an adjuvant on hemodynamic parameters and recovery profile of patients maintained on desflurane for sitting position intracranial tumor surgeries.
Method: 60 ASA class I to III patients undergoing elective sitting position intracranial tumor surgery were randomized to receive either Dexmedetomidine infusion at the rate of 0.25 \(\mu\)g/kg/hr (Group D) or normal saline infusion (Group C) from the time patient was taken on table and continued till the end of dura closure. Monitoring done for hemodynamic changes, minimum alveolar concentration, BIS, recovery endpoints and adverse events.
Result: The heart rate was comparable in both the groups at baseline and decreased significantly in patients of Group D. The mean MAC in patients of Group C was high. The Bispectral Index values decreased significantly in patients of Group C as compared to Group D till the end of the study. The recovery endpoints parameters were significantly lower in patients of Group D as compared to patients of Group C. Ramsay Sedation Score was significantly lower in Group D compared to Group C from the time of discontinuation of anesthesia delivery till the end of 120 mins. This difference was statistically significant as per Student t-test (p<0.05).
Conclusion: Dexmedetomidine infusion started in low dose before surgery maintains hemodynamic stability intraoperatively, reduces the amount of anaesthetic drug required for induction, decreases the requirement of analgesic drug without any residual sedation.

Keywords: Posterior fossa; Neuro anaesthesia; Desflurane; Dexmedetomidine.