Comparison of Efficacy of Dexmeditomidine and Midazolam for Bloodless Surgical Field during Functional Endoscopic Sits Surgery (FESS) under General Anaesthesia

ABSTRACT

Objective: A comparative study to evaluate the efficacy of dexmedetomidine to provide bloodless surgical field in comparison to midazolam in Functional Endoscopic Sinus Surgery (FESS). Methods: 60 patients ASA I or II scheduled for FESS were equally randomly assigned to receive either Inj. Dexmedetomidine in dose of 1 g/kg over 10 min in infusion or Inj. Midazolam 0.02 mg/kg. In both groups, the infusion rate was adjusted to maintain the mean arterial blood pressure (MAP) of 65-70 mmHg. The induction was done using propofol (2.5 mg/kg) and atracurium (0.5 mg/kg). After the intubation, maintenance was achieved with O (50%), N O 2 2 (50%), Inj. Atracurium infusion and Sevoflurane. Intraoperative bleeding was estimated by the surgeon using Boezzart's scale for the evaluation of operative field visibility during the surgery. Hemodynamic variables (MAP and HR) were recorded. Results: Better achievement of MAP control is achieved with Dexmedetomidine compared to Midazolam. Overall intra-operative blood loss was more in Midazolam group compared to Dexmedetomidine group. Conclusion: Both Dexmedetomidine and Midazolam are safe and effective in FESS for controlled hypotension, though Dexmedetomidine provides excellent surgeon's satisfaction without severe hemodynamic changes