Randomized trial compares dexmedetomidine and magnesium sulfate for extubation hemodynamics in surgical patients, highlighting methods to blunt sympathetic surges.
Emerging from general anesthesia (GA) and tracheal extubation can lead to unfavorable effects on hemodynamics, with complications from extubation occurring about three times more often than from intubation (12.6% vs 4.6%). 1 Tracheal extubation may temporarily increase heart rate (HR) and blood pressure (BP) by 10-30% for about 5-15 minutes due to automatic reflex sympathetic response from epipharyngeal to laryngopharyngeal stimulation.2,3 Coughing, straining, and breath holding have also been observed.While these changes are typically minor in healthy individuals, they may be of relevance with comorbidities such as hypertension, 4 coronary artery disease, 5 or cerebrovascular issues.6 Additionally, aggressive extubation
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Maharaj et al. (2025) studied this question.
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