The Effect of Single-Dose Dexmedetomidine on Cough Response During Tracheal Extubation

Introduction: Optimal strategy for smooth, cough less extubation is still not well established. We aimed to study the effect of single dose of dexmedetomidine (0.5ug/kg) given prior to extubation on cough response during extubation.
Methods: 220 patients undergoing laparoscopic cholecystectomy under general anaesthesia were included in the study. Group D (n=110) received IV dexmedetomidine 0.5ug/kg diluted in 100 ml saline and Group S (n=110) received 100ml saline 15 minutes before extubation. Primary outcome was incidence and severity of cough at the time of extubation. Secondary outcome was haemodynamic parameters and sedation. The severity of cough was graded on a four-point scale. Statistical analysis was performed using chi square test and independent t test.
Results: The incidence of coughing was significantly lower in Group D than Group S (49.1% vs.70.9%, p = 0.002). Lower grades of cough was observed more in Group D than Group S (17.2% vs. 30.9% p = 0.018). The mean heart rate and blood pressure were lower in Group D. (p <0.001) Sedation score was similar in both groups. (p=0.07)
Conclusion: Use of single bolus dose of dexmedetomidine prior to extubation reduces the incidence and severity of cough grade. In addition, it also attenuated haemodynamic response to tracheal extubation without affecting recovery.