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PHARMACOLOGICAL METHODS TO DECREASE COUGHING ON EMERGENCE FOLLOWING GENERAL ANESTHESIA WITH TRACHEAL INTUBATION IN LOWER ABDOMINAL SURGERIES

Background: Emergence from anesthesia and extubation induces variant physiological responses including unwanted circulatory and airway reflexes resulting in hyper circulatory manifestations in the form of tachycardia, hypertension, cough, laryngospasm, and bronchospasm. These events may predispose or induce multiple complications either in the operative site or elsewhere in the body. Aim of the Work: To explore various pharmacological perioperative techniques that can be used to achieve a smooth extubation while caring for an uncomplicated patient without significant risk factors for extubation failure. Patients and Methods: Randomized sample for population who were admitted for lower abdominal surgery under general anesthesia with oral endotracheal intubation in Ain-Shams University Hospitals after Ethical Committee approval and starting from January 2021. Results: There is clinical evidence to support the use of Dexmedetomidine, Lidocaine and Dexamethsaone to significantly attenuate excessive coughing, hemodynamic shifts, postoperative sedation and prolongation of time during extubation. Patients‟ characteristics (age and sex), duration of surgery, type of surgery and Oxygen Saturation show non-significant difference between the four groups. Conclusion: The quality of tracheal extubation was better in Dexmedetomidine, Lidocaine and Dexamethasone groups over control group with Dexmedetomidine group being the most favorable in patients requiring General anesthesia with endotracheal intubation for lower abdominal surgeries, without any adverse effects.