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Category: Volume 08 Issue 02 February 2020
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Title: Comparative study of hemodynamics in Intracranial tumor surgeries with clonidine and dexmedetomidine under general anesthesia

Authors: Dr P.V.Sairam, Dr B. Murali Krishna, Dr K.Praveen

 DOI: https://dx.doi.org/10.18535/jmscr/v8i2.111

Abstract

   

Background and Aim: Perioperative hemodynamic stability is of extreme importance while administering general anesthesia to avoid intracranial hemorrhage to profound surgical stimuli associated with craniotomy. Recently alpha 2 agonists clonidine and dexmedetomidine are being used for attenuating these hemodynamic responses. As no studies compared them using intraoperative infusions throughout surgery present study is designed so.

Materials and methods: 60 patients diagnosed with intracranial tumors are randomized into two Groups of C and D of each 30. Group C received clonidine as a bolus of 0.5mic/kg intravenously (IV) 20minutes before induction and intra-operatively iv infusion at 0.5mic/kg/hr after intubation and stopped before starting of skin closure. Similarly, Group D receives Dexmedetomidine at the same doses and same time.Hemodynamics like heart rate and mean arterial blood pressure at intubation, craniotomy, and extubation and side effects of study drugs like bradycardia and hypotension compared.

Results: At intubation, the mean heart rate in Group C is  79.36 ± 7.328beats/ min, and in Group D is 74.33 ± 6.07,p valve for mean heart rate is 0.0053(S). Mean MAP at intubation in Group C is  80.5 ± 7.645 mm Hg, and in Group D is 72.47 ± 5.869 is 0.0001(S). The mean heart rate at extubation in Group C is 71.16 ± 3.355, and in group D 68.57 ± 4.56, and the p-value is 0.0149(S). Mean MAP at extubation in Group C is 71.1± 4.278, and in Group D is 69.03 ± 2.456, and p-value is 0.02733 (S). 2 persons from Group C and 5  from Group D  had bradycardia and  3 in Group C, and 4 in Group D had hypotension episodes, and p valve is 0.13 and 0.68(NS).P valve <0.05 statistically significant (S) and > 0.05satistiocally nonsignificant (NS).

Conclusion: Both drugs caused attenuation of sympathetic responses like heart rate and mean arterial pressure in Intracranial tumor surgeries with an excellent operating field; however, dexmedetomidine is a preferable agent when compared to clonidine, with better hemodynamic stability and a bright surgical condition.

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Corresponding Author

Dr P.V.Sairam