Comparision of the effect of two different doses of Propofol in atteaunation of hemodynamic and cough Response to tracheal extubation among adult elective Surgical patients at jimma medical center, ethiopia 2022

Abstract

Background: Tracheal extubation is the purposeful removal of the endotracheal tube from the trachea. The act of extubation itself is physiologically stressful and is often accompanied by significant hemodynamic changes and respiratory tract complications. Extubation induced hemodynamic and cough response gives less attention by anesthesia professionals and the practice of using appropriate dose of propofol for attenuation of hemodynamic response during extubation lucks uniformity among anesthesia professionals. Objective: The objective of the study was to compare the effect of two different doses of propofol on attenuation of hemodynamic and cough response during extubation among adult elective surgical patients from August 2022 to December 2022 at Jimma medical center. Methods : A comparative cross sectional study were conducted on 102 adult elective surgical patients ages between 18 and 65 who required orotracheal intubation and randomly allocated to control group (n=34), propofol 0.5mg/kg (n=34) and propofol 1mg/kg (n=34). Hemodynamic parameters like heart rate, systolic blood pressure and mean arterial blood pressure were recorded just before residual effects of muscle relaxants were reversed as a baseline value and 1 st , 3 rd , 5 th and 10 minute after extubation. Cough response following extubation was graded as (grade 0, 1, 2 and 3). The hemodynamic parameters were analyzed using one way ANOVA, Post hock –Tukey test, Student unpaired t-test and chi square test and p- value < 0.05 were considered statistically significant. Result: The socio-demographic and clinical characteristics of the respondents were not statistically significant. There were a significant difference between control and propofol groups but there were no statistical significant difference between the two doses; both are effective on attenuation of hemodynamic parameters (heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure) at 1 st , 3 rd , 5 th and 10 minutes and cough response after extubation. Conclusion: There were no significant difference between the two doses. Both intravenous propofol 0.5mg/kg and 1mg/kg when given prior to extubation were effective on attenuation of hemodynamic parameters and cough response following extubation. Anesthetists might consider low dose propofol 0.5mg/kg for attenuation of hemodynamic and cough response to endotracheal extubation