Hemodynamic Stability of the Patients Receiving Intravenous Dexmedetomidine versus Intravenous Propofol Based Sedation in Cervical Disc Surgeries
Intravenous Dexmedetomidine versus Intravenous Propofol
Background: The sedative effect of dexmedetomidine is exercised subcortically and mimics natural sleep. The area of the brain with the highest concentration of alpha2-ARs is the locus coeruleus (LC) in the upper brainstem, which is responsible for arousal, sleep, anxiety, and withdrawal symptoms from drug addiction. It projects into two areas in the thalamus: the ventrolateral preoptic nucleus and the tuberomamillary nucleus. When the alpha2-AR is activated, it inhibits adenylyl cyclase. This results in the reduction of cAMP, with net efflux of K+ (through Ca2+-activated K+ channels) and inhibition of Ca2+ entry into nerve terminals. This hyperpolarises the neuron and suppresses the release of noradrenaline (NA) from the LC. Subjects and Methods: In this prospective study hundred ASA Grades I and II patients between the ages of 20 and 60 years undergoing elective cervical disc surgeries were enrolled after Ethical committee and Scientific committee approval meeting the below selection criteria. Results: The intergroup variation in the SBP during the intubation and till 5 mins after intubation showed a significant lower values in patients with the dexmedetomidine as compared with the propofol (P < 0.001). Conclusion: Patients on dexmedetomidine had significantly better hemodynamic response to Fiberoptic bronchoscopy and intubation compared to propofol group. Heart rate, systolic, diastolic and mean arterial pressures were significantly lower in dexmedetomidine group as compared to propofol group during intubation and at various intervals post intubation.