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A prospective Randomized Double-Blind Study Comparing Adrenaline vs. combination of Adrenaline and Dexmedetomidine in Local Infiltration Block for Ear and Nose Surgeries

Kirti Arvind Kundalwal, Assistant Professor, Dept. of Anesthesia, B.J. Govt. Medical College Pune Maharashtra 411001. , Kirti Arvind Kundalwal1 , Vinaya R. Kulkarni2 , Nanasaheb K. Bhangare3 , Kalpana V. Kelkar4 , Rahul T. Thakur5

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Indian Journal of Anesthesia and Analgesia 5(2):p 209-214, February 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5218.10

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Abstract

Background and Aims: For the achievement of clear bloodless surgical field, local infiltration of adrenaline is used routinely in Ear, Nose and Throat (ENT) surgeries. The present study was intended to study effectiveness of the addition of dexmedetomidine to local infiltration solution of lignocaine and adrenaline and any adverse effect associated with it. Methods: We recruited 80 patients in the age group of 18-65years by randomization posted for tympanoplasty or septoplasty under general anesthesia and divided into two groups of 40 each. Group A received local infiltration of 11.5ml of 2% lignocaine with adrenaline (1:200000) dilution with 0.5ml normal saline while Group D received local infiltration of 11.5 ml of 2% lignocaine with adrenaline (1:200000) dilution with 0.5ml (50µg) of dexmedetomidine. Monitoring involved-Heart rate, Blood pressure, Intraoperative surgical bleeding and Surgeon’s satisfaction score. Intraoperative isoflurane and fentanyl requirement was calculated. Student’s t-test was used for analysing statistical significance in time related variables. Results: Intraoperative tachycardia and hypertension which was seen after infiltration of solution of lignocaine and adrenaline was found to be abolished by addition of dexmedetomidine. Also dexmedetomidine containing solution significantly decreased intraoperative bleeding and thus increased surgeon’s satisfaction. Isoflurane and fentanyl requirement was significantly reduced in study group. Conclusion: Addition of dexmedetomidine to local infiltration solution of lignocaine and adrenaline in ear and nose surgeries provides a good quality surgical field with stable haemodynamics with decreased requirement of other agents for the purpose of clear field, enhancing safety of the procedure and patient and cost effectiveness.

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5218.10

Keywords

Adrenaline; Clear Bloodless Surgical Field; Dexmedetomidine; Hypotensive Anesthesia. 

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