BACKGROUND-Goals of neuroanaesthesia are to provide good operating conditions and to ensure stable cerebral hemodynamics without sudden increase in intracranial pressure or acute brain swelling.

Objectives-To compare dexmedetomidine and fentanyl in relation to:1.Hemodynamic responses during induction,laryngoscopy, intubation,skull clamping,skin incision and extubation.2.Recovery profile.3.Side effects during intra and postoperative period.

METHODS-The prospective randomized study was conducted in S.N.M.C Agra.50 patients of ASA Grade I and II who underwent craniotomy under general anaesthesia were divided in GROUP D-Patients received dexmedetomidine infusion( loading dose-1 μg/kg over10mins and maintainance.04-.05μg/kg/hr) GROUP F-Patients received fentanyl infusion( loading dose - 4μg/kg,maintainance infusion-0.02-0.03μg/kg).

Hemodynamic parameters –H.R and B.P were monitored at start of surgery,at intervals of 5 mins and at extubation.Spo2 and EtCO2 were monitored. Recovery time from anaesthesia,cerebral relaxation score and side effects(hypotension,bradycardia,shivering,nausea,vomiting) were recorded.

RESULT-H.R and B.P values were lower in D as compared to F.Cerebral swelling status was lower in D as compared to F.Recovery from anaesthesia was fast in D as compared to F as suggested by lesser extubation time,time for eye opening,time to follow verbal commands.Side effects were similar in both groups

DISCUSSION- Dexmedetomidine reduced the hemodynamic response to laryngoscopy and intubation,surgical stimulation and extubation in patients undergoing supratentorial surgeries

CONCLUSION-Dexmedetomidine and fentanyl both were effective during craniotomy for controlling perioperative hemodynamic responses but dexmedetomidine was better in producing cerebral relaxation.Dexmedetomidine also reduced fentanyl consumption during the perioperative period and shortened the recovery time thus reducing post anaesthetic care unit stay.