Comparison between intravenous dexmedetomidine and esmolol for induced hypotension during functional endoscopic sinus surgery and modified radical mastoidectomy
Journal Title: Medpulse International Journal of Anesthesiology - Year 2017, Vol 8, Issue 1
Abstract
Aim: Bleeding is one of the major problems during surgery which reduces operative field visibility and recognition of anatomical landmarks becomes quite difficult. We aim to compare Dexmedetomidine and esmolol for controlled hypotension during functional endoscopic sinus surgery (FESS) and Modified Radical Mastoidectomy (MRM) as both the procedure use endoscope/microscope and a small amount of blood can obscure the field of surgery. Material and Methods: Sixty patients of American Society of Anesthesiologist physical status I and II undergoing general anesthesia for FESS and MRM were randomly allocated in two group of 30 patient each. Group D received Dexmedetomidine in a loading dose of 1 mcg/kg over 10 min followed by an infusion of Dexmedetomidine 0.5 mcg/kg and Group E received Esmolol 1 mg/kg as loading dose followed by Esmolol 0.5mg as maintenance in infusion. Both the group were compared for intraoperative hemodynamic parameters, postoperative effects. The post operative sedation was assessed with Ramsay Sedation Score. Results: Both Dexmedetomidine and Esmolol drugs produce desired hypotension and improved surgical field but ideal condition were achieved by Dexmedetomidine. Intraoperative mean Heart rate/min in Group D was 70.69±2.84 vs.74.39±2.66 in group E, which is statically significant.(p =0.000). The mean blood pressure (MAP) in group D was 70.63±077 and 73.09±0.81 in group E, which is also statically significant (p<0.001) and shows that dexmedetomidine is better for intraoperative control of MAP. Postoperative incidences nausea (group E 20% vs.13.33% in group D), vomiting (group E 6.7% vs. 3.3% in group D). The mean Ramsay Sedation Score in group D was 3.0±0.98 whereas it was 2.3±0.85 in group E. Conclusion: Both Dexmedetomidine and Esmolol can be used as a hypotensive agent in FESS and MRM surgery, however Dexmedetomedine is more effective than Esmolol in providing intraoperative hypotension. Also Dexmedetomidine have less complication or side effects. Sedation score in postoperative period is more in patients receiving Dexmedetomidine. However, the patients were awake and responded to commands.
Authors and Affiliations
Ajay Kumar, Ankur Garg, Malti Agrawal
Keywords
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- EP ID EP440530
- DOI 10.26611/1015816
- Views 158
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