Comparison between clonidine and dexmedetomidine in suppressing cough response during tracheal extubation : A controlled study

Tracheal extubation is a very crucial event in the course of general anaesthesia. The Difficult Airway Society has given guidelines for successful extubation but there is no uniform consensus regarding criteria for smooth extubation1.  Extubation causes reflex sympathetic discharge due to epipharyngeal and laryngopharyngeal stimulation. While strategies to blunt intubation response are very well studied, there is very little information on the process of smooth extubation. Smooth tracheal extubation is defined as no gross purposeful muscular movement, such as coughing, within 1 minute of tracheal tube removal.

Extubation stress response can be deleterious as it can cause   hypertension, tachycardia and exaggerated airway reflexes  A few of the drugs have been studied for prevention and treatment of these undesirable effects such as opioid analgesics, local anaesthetics like Lignocaine, Ketamine, and Dexmedetomidine. The centrally acting highly selective alpha-2 agonists Dexmedetomidine and Clonidine have sympatholytic, analgesic, sedative properties without any effect on respiration.

b. Need for the study:

There is paucity in the literature about the process of conducting smooth extubation, especially with clonidine. Considering this, the study is aimed to compare the effectiveness of Clonidine and Dexmedetomidine in evaluating cough score in patients undergoing elective surgeries under General Anaesthesia