Comparision of Dexmedetomidine, I.V. Lignocaine and Ett/Ambu-Lma Exchange for Smooth Emergence in Tympanoplasty Surgery: A Randomized Prospective Study

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S. Sivakumar, Vinodh Mani, R. Sankar Anand, R. Paul Rafson Jani

Abstract

Background and Aim: Exchange of the endotracheal tube (ETT) with laryngeal mask airway (LMA) before emergence from anaesthesia, use of dexmedetomidine infusion due to its anxiolytic, analgesic qualities and less respiratory depressant effects, and I.V Lignocaine  has long been used to modulate unwanted airway and circulatory reflexes, reduced the complications during extubation with better surgical outcome especially in otolaryngology surgeries. Aim of this randomized-prospective study is to compare the effectiveness of ETT/ ambu laryngeal mask ALMA) exchange , dexmedetomidine and I.V lignocaine  for smooth extubation in patients undergoing elective tympanoplasty.


Methods and Materials: 60 patients undergoing elective tympanoplasty under general anaesthesia were randomly divided into three groups- 20 patients in each group. Group I: ALMA (ambu laryngeal mask airway) used for ETT/LM exchange Group II: Dexmedetomidine 1.0 mcg/kg given 10 minutes before the end of surgery and group III : I.V lignocaine 2mg/kg given 10 minutes before end of the surgery. 


Results: 18 patients in group I, 17 patients in group II and 14 patient in group III had smooth extubation. All cases in Group I, Group II and Group III maintained a regular respiratory pattern during the study without desaturation and maintaining adequate tidal volume. There was insignificant difference in hemodyamic parameter between the groups.


Conclusion: ETT/ALMA exchange and dexmedetomidine 1.0 μg/kg along with sevoflurane produced better smooth emergence than I.V lignocaine in patients undergoing elective tympanoplasty surgery.

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