Comparison Of Dexmedetomidine Infusion/ Midazolam‐fentanyl Infusion In Monitored Anesthesia Care For Sedation & Olegamic Field For Tympanoplasty & Modified Mastoidectomy

Indian Journal of Applied Basic Medical Sciences
Year: 2019, Volume: 21(B), Issue. (2)
First page: (227) Last page: (233)
Online ISSN: 2249-7935
Print ISSN: 0975-8917
doi:

Comparison Of Dexmedetomidine Infusion/ Midazolam‐fentanyl Infusion In Monitored Anesthesia Care For Sedation & Olegamic Field For Tympanoplasty  & Modified Mastoidectomy
Gargi Bhavsar1, Manisha kapdi2*,Akruti3, Prerak4, Madhu5
1Assistant professor, 2Associate professor, 3-5Resident,Department of anaesthesia, NHL Mun. medical college and vs Hospital Ahmedabad Pin 380006 
Corresponding author email id: manisha_kapdi@ yahoo.com  

Online Published on 02-Jul-2019

ABSTRACT

Background: Midazolam-fentanyl combination, has been used medication given for sedation in tympanoplasty and mastoidectomy because of a number of beneficial effects. However, Dexmedetomidine is a highly selective α2-adrenoceptor agonist is emerging as preferred choice present era. Aims & objectives: The aim of the study is to compare hemodynamic stability and sedation under Dexmedetomidine infusion versus Midazolam-fentanyl infusion during tympanoplasty and modified radical mastoidectomy done under monitored Anesthesia care Material & Methods: After proper counselling and written informed consent from patients, 60 patients of age group 18 to 60 years of ASA grade I & II were selected and divided in to two groups: Group A : Inj. Dexmedetomidine 1µg/kg over 10 min bolus through infusion pump followed by infusion of 0.5µg/kg/hr (n= 30). Group B: Inj. Midazolam 0.02 mg/kg & inj fentanyl 1 mcg/kg IV over 10 min bolus through infusion pump followed by infusion of inj. midazolam 0.02mg/kg/hr & Inj fentanyl 1 mcg/kg/hour. (n= 30). Noninvasive blood pressure, heart rate and sedation level were monitored. The surgeons and patients were asked to rate their satisfaction, as poor, satisfactory, good, excellent. OBSERVATIONS & RESULTS: There was significant reduction in systolic blood pressure after bolus infusion of Dexmedetomidine in group A.(p<0.05) between group A and group B was not statistically significant difference found in diastolic blood pressure of both the groups. There was a significant reduction in heart rate in group A as compared to group B Surgeon’s satisfaction score and patient’s satisfaction score both were high in group A compare to group B. Conclusions: For monitored anesthesia care(MAC) in middle ear surgeries performed under local anesthesia, inj. Dexmedetomidine is a good alternative over inj. Midazolam Fentanyl combination for sedation,& Olegamic field.

Keywords

Dexmedetomidine, Midazolam, ENT surgeries, Tympanoplasty ,mastoidectomy, Monitored anaesthesia care( MAC)

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