BACKGROUND AND AIMS Endotracheal extubation is one of the frequently performed procedures in the practice of anaesthesia. Endotracheal extubation is the translaryngeal removal of a tube from trachea via nose or mouth. Complications that occur during and after extubation are three times more common than that occurring during tracheal intubation and induction of anaesthesia. Hypertension and tachycardia are well documented events during extubation. Respiratory complications associated with tracheal extubation are coughing and sore throat (ranges from 38-96%), laryngospasm, bronchospasm which leads to hypoxemia. Laryngospasm is the commonest cause for postextubation upper airway obstruction. Dexmedetomidine is a highly selective α2 adrenoreceptor agonist (α2::α1 1620:1). α2 agonists decrease the sympathetic outflow and noradrenergic activity thereby counteracting hemodynamic fluctuations occurring at the time of extubation. 1 Dexmedetomidine has been recently introduced in India, not many studies have been done using the same in order to obtund the extubation response. Hence this present study is conducted to see the effects of "dexmedetomidine (0.5 mcg/kg) on extubation response". MATERIALS AND METHODS The first 50 cases presenting for surgery during the study period were included after satisfying the inclusion and exclusion criteria. After obtaining informed written consent, patients were randomly divided into 2 groups. Group A: Dexmedetomidine: Received Dexmedetomidine infusion (25 patients). Group B: Control Group: Received 0.9% sodium chloride as placebo (25 patients). RESULTS There was a significant difference in the HR, SBP, DBP, and MAP in both the groups. Group A receiving dexmedetomidine showed a statistically significant difference (P<0.05) in all the parameters from 5 mins. after starting administration of agent till 20 mins. after extubation. Few adverse effects like bradycardia and hypotension were noted with group A compared to group B, but none of them required treatment. None of the patients in group A and group B had any other side effects like respiratory depression, laryngospasm, bronchospasm and undue sedation. There was no significant difference in SpO2 between both the groups. CONCLUSION Based on our results, we concluded that administration of dexmedetomidine 0.5 mcg/kg infusion 15 mins. before extubation, stabilises hemodynamics and facilitates smooth extubation.

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The aim of the study is: 1. To observe the onset time of sensory and motor blockade. 2. To compare levels and duration of sensory and motor blockade. 3. And to observe associated complications in subarachnoid block using 2.5 mL, 3 mL and 3.5 mL of 0.5% bupivacaine (hyperbaric). MATERIALS AND METHODS The prospective randomised clinical study was carried out on 90 patients belonging to ASA grade I and II, posted for elective urogenital, lower abdominal and lower extremities surgeries, under spinal anaesthesia. 90 patients were randomly divided into three groups using envelope method with 30 patients in each group. 1. Group A: Patients received 2.5 mL of hyperbaric solution of 0.5% bupivacaine. 2. Group B: Patients received 3.0 mL of hyperbaric solution of 0.5% bupivacaine. 3. Group C: Patients received 3.5 mL of hyperbaric solution of 0.5% bupivacaine. Immediately after the injection, the patient was positioned in the supine horizontal position and the following parameters were evaluated. Time of onset of sensory blockade, Maximum level of sensory blockade, Duration of sensory blockade, Time of onset of motor blockade, Maximum level of Motor blockade, Duration of motor blockade. RESULTS The onset of sensory and motor blockade was faster with the increasing volumes of the drug. Higher levels of sensory blockade were achieved with the increasing drug volumes. The duration of sensory and motor blockade increased with the increasing volumes of drug. The duration of motor block was directly proportional to the volume of the drug injected. CONCLUSION We conclude from our study that the doses of 0.5% hyperbaric bupivacaine can be titrated according to the level and duration of sensory and motor blockade desired using minimum amount of drug necessary. The cardiovascular stability was better at lower volumes of the drug.