A comparative study of Dexmedetomidine versus midazolam with fentanyl for monitored anaesthesia care in tympanoplastyunder local anaesthesia

Journal Title: Medpulse International Journal of Anesthesiology - Year 2019, Vol 10, Issue 2

Abstract

Background and Aims: Monitored anaesthesia care (MAC) is a procedure in which the local anaesthesia(LA) and sedation provided using different drugs. We conducted this comparative study to see the safety and efficacy of Dexmedetomidine and midazolam with fentanyl for tympanoplasty under MAC. Methods: Fifty patients of age between 18 to 60 years of either sex posted for tympanoplasty under MAC were randomly allocated into two groups. Group D (n = 25) patient received intravenous (IV) dexmedetomidine 1 µg/ kg as bolus followed by an infusion 0.2 µg/kg/h. Group MF (n =25) patient received IV midazolam 0.05 mg / kg plus fentanyl 1.5µg/ kg as bolus followed by 0.2 ml/kg/h normal saline as an infusion. Sedation was titrated according to Ramsay Sedation score of 3. Rescue doses of midazolam 0.01mg/kg IV as sedation and fentanyl 1µg/ kg IV as analgesic was given when required, maximum 3 doses allowed.Patient’s oxygen saturation, hemodynamics, and need for intraoperative rescue sedation/analgesia were assessed as primary outcome. Surgeon satisfaction score were assessed as secondary outcome.The data were analyzed by Chi-square and unpaired t-test.Result: Number of rescue analgesia /sedation/infiltration/ was less in dexemeditomidine group (2/2/4) compared to group MF (14/14/20). Surgeon satisfaction score was higher in group D than group MF (P=0.001). Haemodynamically patients were stable in both the groups. Conclusion: Compared to midazolam with fentanyl, dexmedetomidine is a better alternative as it is associated with good haemodynamic control, without respiratory depression, lower pain scores and greater surgeon satisfaction.

Authors and Affiliations

Jigisha Badheka, Pratik M Doshi, Peram Shrividhya, Jaykishan Gol, Vandana Parmar

Keywords

Related Articles

Comparison of intramuscular atropine and glcopyrrolate in children undergoing various surgical procedures under general anaesthesia

Background: Antiocholinergic premedication in paediatric patients undergoing surgeris under general anaesthesia plays in important role in blocking the potentially dangerous vagal reflexes and in also controlling the oro...

The efficacy of two different doses of gabapentin (300mg and 600mg) along with NSAID (diclofenac transdermal patch 100mg) in postoperative pain management following abdominal hysterectomy

Context: Gabapentin, an antiepileptic drug has a role in acute postoperative pain management due to its anti hyperalgesic property. Pre-emptive analgesia is the recent concept in multi modal pain management. The purpose...

Effect of intrathecal labor analgesia using fentanyl 25μg alone and fentanyl 20μg plus bupivacaine 2.5mg on the progress of labor

Background: The aim of this study was regarding the effect of intrathecal analgesia using fentanyl or fentanyl and bupivacaine combination during normal vaginal delivery on onset and duration of analgesia, pain scores in...

A prospective randomised study to compare serum lactate level in patients receiving induced controlled hypotension with propofol and isoflurane for functional endoscopic sinus surgery

Lactate which the metabolic end product of anaerobic metabolism is being used as a marker of hypoperfusion. It is seen is various conditions which decrease tissue perfusion and hence used as a marker for inadequate cellu...

A randomized, prospective, comparative study to evaluate the haemodynamic changes of 3ml of 0.5% isobaric levobupivacaine and 3ml of 0.5% isobaric ropivacaine for spinal anaesthesia in patients undergoing elective lower limb orthopaedic surgeries

Background: Levobupivacaine and Ropivacaine have been recently introduced in India, Although levobupivacaine is theoretically more potent than ropivacaine, clinical studies show conflicting results in terms of anesthetic...

Download PDF file
  • EP ID EP616672
  • DOI 10.26611/101510217
  • Views 194
  • Downloads 0

How To Cite

Jigisha Badheka, Pratik M Doshi, Peram Shrividhya, Jaykishan Gol, Vandana Parmar (2019). A comparative study of Dexmedetomidine versus midazolam with fentanyl for monitored anaesthesia care in tympanoplastyunder local anaesthesia. Medpulse International Journal of Anesthesiology, 10(2), 152-156. https://europub.co.uk/articles/-A-616672