A Comparative Evaluation of Dexmedetomidine and Midazolam in Monitored Anaesthesia Care for Tympanoplasty

Journal Title: Indian Journal of Anesthesia and Analgesia - Year 2018, Vol 5, Issue 3

Abstract

Introduction: Monitored Anaesthesia care (MAC) has been defined by the American Society of Anaesthesiologists as a diagnostic or therapeutic procedure done under local anaesthesia along with sedation and analgesia. Advantages of performing tympanoplasty under MAC with local anaesthesia are less bleeding, improved post-operative analgesia, early and smooth recovery and discharge from hospital with least expenditure. The biggest advantage is intra-operative communication and assessment of hearing in the patient. Aim: The study was done to evaluate the efficacy of dexmedetomidine and midazolam for intra-operative sedation and analgesia in monitored anaesthesia care and to compare and assess any adverse effects in different groups of study. Methodology:The study was Conducted in the Department of Anaesthesiology, Gandhi Medical College and Hamidia Hospital, Bhopal on ASA Grade I and II patients scheduled for tympanoplasty. 90 patients of either sex of ASA Grade I and II, aged between 16 and 40 years were studied.All patient were premedicated with injection glycopyrolate 0.01mg/kg IV and Inj pentazocine 0.3 mg/kg over 1 min. Group A received Dexmedetomidine: Bolus dose 1mcg/kg IV followed by 0.4mcg/kg per hour, and Group B received Midazolam: Bolus dose of 0.04 mg given over 1 min. Oxygen supplementation through nasal catheter was given. Sedation was titrated to Ramsay Sedation score of ³3. Rescue sedation with Midazolam 0.01mg/kg was given if RSS was <3 . Surgery was allowed to commence when Visual Analogue Scale (VAS) was <3. Sedation was assessed using Ramsay sedation Scale. Result and Conclusion: Sedation with Dexmedetomidine was found to be better alternative to midazolam in monitored anaesthesia care performed in minor ENT surgical procedures. It provides a calm sedated patient. Also, fall in the HR and MAP was seen in more number of patients of Group A than in Group B. This caused decreased bleeding, thus providing bloodless surgical field comfortable for the surgeon.

Authors and Affiliations

Ruchi Tandon

Keywords

Related Articles

Comparative Study of Postoperative Analgesia with Epidural Bupivacaine Versus Epidural Bupivacaine and Tramadol

Background: Pain is constant and predominant complaint of individual following, most surgical intervention. Epidural narcotics have been in large number of studies for treatment of postoperative epidural n arcotic like m...

Evaluation of Low Dose Dexmeditomedine as an Adjuvant to Bupivacaine 0.25% in Supraclavicular Brachial Plexus Blocks

Context: The assessment of the efficacy of low dose (30 micrograms) of dexmeditomedine added to 0.25% bupivacaine was studied for the prolongation of the duration of sensory and motor block in supraclavicular brachial pl...

Comparitive Evaluation of Propofol with Ketamine versus Propofol with Fentanyl in Total Intravenous Anaesthesia for Day Care Surgeries

Aim of the Study The aim of the study is to compare the recovery times when Propofol with Fentanyl or Propofol with Ketamine are used for maintenance of anaesthesia in day case surgery and also to determine which agent c...

Comparative Study of Epidural Bupivacaine with Butorphanol and Bupivacaine with Tramadol for Postoperative Pain Relief in InfraUmblical Surgeries

Introduction: To compare the efficacy of combination of epidural local anesthetic with tramadol and butorphanol in infra­umblical surgeries. Aims and Objectives: To evaluate duration of analgesia, analgesic efficacy, and...

A Comparative Study of Right and Left IJV Cannulation Using Surface Anatomy or USG Guidance: A Prospective Randomized Study

Context: Internal jugular vein (IJV) is cannulated in a variety of patients. Left IJV cannulation sometimes becomes necessary. Aim: This study was done to evaluate the usefulness of ultrasonography (USG) in performing le...

Download PDF file
  • EP ID EP533486
  • DOI 10.21088/ijaa.2349.8471.5318.17
  • Views 109
  • Downloads 0

How To Cite

Ruchi Tandon (2018). A Comparative Evaluation of Dexmedetomidine and Midazolam in Monitored Anaesthesia Care for Tympanoplasty. Indian Journal of Anesthesia and Analgesia, 5(3), 456-459. https://europub.co.uk/articles/-A-533486