Dexmedetomidine as a Sole Anaesthetic Agent in Neurosurgical Procedures

Abstract

BACKGROUNDDexmedetomidine is an alpha-2 agonist gaining popularity in neurosurgery due to its unique properties as a sedative, anxiolytic and anaesthetic sparing effects without respiratory depression. We designed this study to assess the efficacy of Dexmedetomidine as a sole anaesthetic agent in neurosurgical cases lasting less than 90 min on spontaneous ventilation. METHODSAfter ethical committee approval and informed consent, adult patients of either gender ASA 1 or 2 of age group 18-60 years undergoing neurosurgical procedures lasting less than 90 min were included. All patients received standardized premedication and induced with IV Inj Fentanyl 2 mcg/kg and Inj. Dexmedetomidine bolus 1 mcg/kg (Over 10 min). All patients were put on Hudson's face mask on spontaneous ventilation with 4 L/min oxygen. All patients maintained only with Inj. Dexmedetomidine infusion at 0.4-0.7 mcg/kg/hr titrated to response Parameters-Haemodynamics, Post Induction sedation scores, Blood glucose, Patient movement at various stimuli, postoperative SOCA scores, analgesic requirement for the first 6hrs after surgery were noted. Data collected accordingly. RESULTSThere was a statistically significant fall in the heart rate, systolic, diastolic and mean blood pressure (p-0.000) during infusion of Dexmedetomidine. There was no reduction in arterial oxygen saturation, no significant change in blood glucose (p-0.900). There were eight events of movement during the procedure requiring administration of fentanyl. Recovery of all patients was good. The mean SOCA score was 8.7±1.4. Incidence of PONV and need for rescue analgesia were not there in most of the patients.