Pramod Kumar Palai1, Sheela Ekka2, Mahendra Ekka3, Saurabh Agrawal4, Sapan Kumar Jena5
BACKGROUND
Middle ear surgeries done under local anaesthesia require adequate patient
sedation and analgesia to prevent patient anxiety and movement during surgical
procedures. This study was undertaken to compare dexmedetomidine and
propofol for their sedative and analgesic properties, safety profile, adverse events
and recovery profile in patients undergoing middle ear surgery under monitored
anaesthesia care.
METHODS
This is a prospective observational study. 96 patients of both sexes, of American
society of anaesthesiologist (ASA) grade I or II, between 18 - 60 years of age were
randomly divided into two groups; group D and group P consisting of 48 patients
each. Patients in group D received a loading dose of injection dexmedetomidine 1
μg / kg I.V. over 10 minutes followed by an infusion at a rate of 0.5 μg / kg / hr.
Patients in group P received a loading dose of injection propofol 75 μg / kg / min.
I.V. over 10 min followed by an infusion at a rate of 50 μg / kg / min. Time taken
to achieve the modified Aldrete score of 10 was compared between both the
groups. Before discharge from post anaesthesia care unit (PACU), patient’s
satisfaction with sedation & surgeon satisfaction was recorded on Likert scale.
Time to rescue analgesia was compared.
RESULTS
The Bi-Spectral Index values in intra-operative period were on the lower side in
the group D as compared to the corresponding values in the group P, but P values
were statistically insignificant suggesting that both dexmedetomidine and propofol
produced similar sedation. Time to rescue analgesia was greater for group D.
CONCLUSIONS
Having similar sedation effect, dexmedetomidine was better than propofol for
sedation in patients undergoing middle ear surgery under monitored anaesthesia
care.
