A Comparative Observational Studybetween Dexmedetomidine V/S Combination Of Midazolam-Fentanyl For Tympanoplasty Surgery Under Monitored Anesthesia Care

ABSTRACT

AIMS AND OBJECTIVES:Comparison of efficacy of dexmedetomidine v/s combination of midazolam-fentanyl during monitored anaesthesia care in tympanoplasty with special emphasis on the sedative properties and the effectiveness of sedation, the number of doses of rescue analgesics given and the haemodynamic parameters measured.MATERIALS AND METHOD:60 patients aged between 15-60 years undergoing tympanoplasty under local anaesthesia were divided into Group A patients received intravenous dexmedatomidine in the dose of 1μg/kg over10 minutes and group B patients received combination of intravenous midazolam 0.02mg/kg and 1μg/kg fentanyl over 10 minutes. Sedation was titrated to Ramsay sedation score (RSS) of three. Vital parameters, intra operative pain intensity by visual analogue scale (VAS) >3, rescue analgesic given if required in the form of fentanyl 1μg/kg was recorded.RESULTS:The mean sedation score in group A is 3.18 ± 0.19 and in group B is 3.03 ± 0.21(p>0.05).Intra operative heart rate and mean arterial pressure in group A were lower than the base line values and the corresponding values in group B (p<0.05).Group A patients have less requirement of rescue analgesic as compared to the midazolam-fentanyl group (40%).CONCLUSION:Dexmedetomidine and combination of Midazolam fentanyl were comparable in the effectiveness of sedation. The lesser requirement of rescue analgesics and decrease in MAP facilitating improved surgical field makes Dexmedetomidine a better choice due to sedative effect and control over hemodynamics in ENT surgical procedures.