A comparative study of combination of dexmedetomidine and midazolam versus combination of midazolam and fentanyl for modified radical mastoidectomy under monitored anaesthesia care
Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 2
Abstract
Background: Monitored anaesthesia care (MAC) has gained importance in anaesthesia for both diagnostic and therapeutic procedures in view of providing safe sedation, controlling patient’s anxiety and pain control. MAC typically involves administration of local analgesics with IV sedatives, anxiolytics and/or analgesic drugs and is widely used in many ENT surgical procedures. The present study was carried out to compare the sedative and hemodynamic changes of combination of dexmedetomidine and midazolam versus midazolam and fentanyl during modified radical mastoidectomy. Material and Methods: 100 patients of ASA grade I and II, posted for modified radical mastoidectomy were randomly divided in two groups of 50 each. Group DM received injection dexmedetomidine 1 μg/kg and injection midazolam 0.06 μg/kg as loading dose followed by infusion of dexmedetomidine 0.5 μg/kg/hr, while group MF received injection midazolam 0.06 μg/kg and injection fentanyl 1 μg/kg as loading dose followed by infusion normal saline as placebo. Both the groups were studied with respect to the amount of sedation, hemodynamic changes and surgeon satisfaction. Results: The difference in the Ramsay sedation score and visual analogue scale was statistically significant in the two groups with significant sedation in DM group as compared to MF group. Also the number of doses of rescue analgesics, rescue sedation and rescue local infiltration was significantly less in DM group. The patient and surgeon satisfaction score was more in DM group than the MF group and the difference was statistically significant. The heart rate and blood pressure were significantly lower in DM group during administration of loading dose but were stable throughout. Conclusion: Finally to conclude, combination of dexmedetomidine and midazolam is better than combination of midazolam and fentanyl in modified radical mastoidectomy done under monitored anaesthesia care.
Authors and Affiliations
Poonam K Raipurkar, Aparna G Kulkarni, Abhimanyu S Tarkase
Keywords
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- EP ID EP589650
- DOI 10.26611/10151023
- Views 132
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