Introduction: In general anaesthesia, commonly due to sympathetic responses patients develop tachycardia and increased secretion and bronchospasm while extubation. Fentanyl and dexmedetomidine are well known to suppress airway reflexes during airway procedures. Aim: This study is design to compare the effects of fentanyl 1 µg/kg and dexmedetomidine 0.75 µg/kg in attenuating airway and circulatory reflexes during emergence and extubation of the endotracheal tube. Materials and Methods: This double-blind, randomized, controlled study was done in fifty patients undergoing surgery under general anaesthesia belonging to (ASA) physical status 1 or 2. Study drugs dexmedetomidine (Group D) & Fentanyl (Group F) was given 15 min before the end of surgery as an infusion and over 15 min post extubation. Hemodynamic parameters and patient response for laryngoscopy like respiratory pattern, airway status and oral suctioning and during extubation were graded. Discussion: Aside from measurably huge drop in BP at 5 min of medication organization which reacted to liquid bolus in the dexmedetomidine assemble there were no unfriendly symptoms amid the examination time frame. Both groups had a similar duration of recovery from anesthesia. Dexmedetomidine before 15 minutes of extubation obtain better results. Dexmedetomidine was found to produce hypotension at 5 min of drug infusion and improved with fluid bolus; HR was stable throughout the study period. Conclusion: Extubation quality was found to be superior in dexmedetomidine group with patients arousable and tolerating suctioning and extubation. Whereas in fentanyl group, patients were awake during extubation and had tachycardia after extubation.

Background and Aims: Alpha (α-2) adrenergic agonists have both analgesic and sedative properties when used as an adjuvant in regional anesthesia. A prospective randomized double-blind study was carried out to evaluate the efficacy of epidural route and to compare the efficacy and clinical profile of dexmedetomidine and clonidine as an adjuvant to bupivacaine with special emphasis on their quality of analgesia, sedation and the ability to provide the smooth intra-operative and postoperative course. Material and Methods: The study was conducted in prospective, randomized and double-blind manner. It included 60 American Society of Anesthesiologists Class I and II patients undergoing lower limb surgery under epidural anesthesia. Patients were randomly divided into Group A receiving 0.5% isobaric bupivacaine 15 ml with dexmedetomidine 1 μg/kg and Group B receiving 0.5% isobaric bupivacaine 15 ml with clonidine 2 μg/kg epidurally. Onset and duration of sensory and motor blocks, duration of analgesia, sedation, and adverse effects were assessed. Results: Demographic data, surgical characteristics cardio-respiratory parameters, side-effect profile were comparable and statistically not significant in both the groups. However, sedation scores with dexmedetomidine were better than clonidine and turned out to be statistically significant. The onset times for sensory and motor blocks were significantly shorter in Group A as compared to Group B. The duration of analgesia and motor block was significantly longer in A Group as compared to Group B. Conclusion: Dexmedetomidine is a superior neuraxial adjuvant to bupivacaine when compared to clonidine for early onset of analgesia, superior intra-operative analgesia, stable cardio-respiratory parameters, prolonged postoperative analgesia and providing patient comfort.