الفهرس 
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Abstract
Perioperative pain management and prevention of stress response to laryngoscopy and intubation, especially in in patients who have hypertensive heart diseases, are of great concern in recent anaesthesia practice. In paediatric Anaesthesia, all the Anaesthesiologists care about smooth recovery through prevention of Emergence agitation after the use of sevoflurane as inhalational Anaesthetic.
Alpha 2-adrenoceptor agonists are being increasingly used in anaesthesia and critical care as they not only decrease sympathetic tone and attenuate the stress responses to anaesthesia and surgery; but also cause sedation and analgesia. They are also used as adjuvant during regional anaesthesia. Clonidine, which was initially introduced as antihypertensive, is the most commonly used alpha 2 -agonist by anaesthesiologists. Dexmedetomidine is the most recent agent in this group approved by FDA in 1999 for use in humans for analgesia and sedation.
This study was conducted on 280 patients of both sexes, with ASA physical status I or II and there ages were ranging between 2-80 years, subjected to elective surgical procedures. Dexmedetomidine was added either intravenously or Intrathecally and Epidurally to demonestrate its efficacy as analgesic, sedative anxiolytic drug.
All Patients were generally monitored with ECG, Pulse Oximeter, Capnography and non-invasive blood pressure. They were devided into main three groups as follow:
group I: General Anaesthesia
Adult and Paediatric Anaesthesia (80 patients).
- To attenuate C.V response to laryngoscopy and intubation.
- For postoperative analgesia.
- To decrease postoperative agitation in children after sevoflurane Anaesthesia.
group II: Regional Anaesthesia
- Subgroups (IIa1-6) Intrathecal, 80 patients, and epidural 40 patients as an additive to the local anaesthetics.
- IVRA in 40 patients, as an additive to local anaesthetics.
group III: ICU (40 patients), As a sedative for mechanically ventilated patients.
Haemodynamic stability and side effects of the study drugs were compared in each group, also sensory and motor block characteristics in groups of regional anaesthesia were compared too
group I: General Anaesthesia (G.A): The use of dexmedetomidine for Preoperative sedation and attenuation of hemodynamic response to endotracheal intubation;
After obtaining Ethics Committee approval, 40 patients undergoing general abdominal surgical procedures were enrolled in this study.
The study was designed in a placebo controlled, double blinded, randomized, prospective fashion. The patients were randomly separated by closed envelope method into two equal groups.