Projects

ABSTRACT
Introduction: Maintaining stable haemodynamics throughout
oral and maxillofacial surgeries helps to decrease intraoperative
bleeding and thus improves the surgical field avoiding unnecessary
damage to vital structures and tissues. Dexmedetomidine
improves haemodynamic stability when used as an adjuvant during
general anaesthesia. Limited studies have been done using low
dose of dexmedetomidine for the attenuation of haemodynamic
stability perioperatively in oral oncological surgeries.
Aim: To study the effect of two doses of dexmedetomidine,
0.4 mcg/kg/hr, 0.2 mcg/kg/hr and normal saline (0.9%) on
haemodynamic stress response in patients undergoing elective
oral oncological surgeries.
Materials and Methods: The present study was a randomised
control study. After institutional Ethical Committee clearance, one
twenty patients of American Society of Anaesthesiologists (ASA)
physical grades I and II aged between 18-65 years, undergoing
elective oral oncological surgeries under general anaesthesia
were enrolled. Patients were randomly assigned to 3 groups with
40 patients in each group. Group A received dexmedetomidine
0.4 mcg/kg/hr, Group B received dexmedetomidine 0.2 mcg/kg/
hr and Group C received normal saline. The infusion was initiated
15 minutes prior to pre-oxygenation and continued intraoperatively
till the beginning of skin closure. Parameters noted were Heart
Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure
(DBP) and Mean Arterial Pressures (MAP). Any adverse effects
during the observation period were also noted. Statistical tests
done were analysis of variance (ANOVA), Post-Hoc Tukey’s test,
Chi-square, Nonparametric setting for Qualitative data analysis.
Results: Intravenous (lV) dexmedetomidine 0.4 mcg/kg/
hr effectively attenuated haemodynamic stress response to
intubation and surgical stimuli throughout the observation
period compared to 0.2 mcg/kg/hr and saline, being statistically
significant (p<0.05). No significant side effects were noted.
Conclusion: Inj. dexmedetomidine 0.4 mcg/kg/hr IV is the
minimum effective dose required to attenuate the haemodynamic
stress response to both intubation and surgical stimulus
intraoperatively in patients undergoing oral oncological surgeries.