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Dexmedetomidine as an Anaesthetic Adjuvant in ENT Surgeries

Sandhya M.K., Assistant Professor, Kanachur Institute of Medical Sciences, Mangalore. 2Former Resident, Department of Anaesthesiology, Government Medical College, Surat. , Mohan Sandhya1 , Gohel Sonal2

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Indian Journal of Anesthesia and Analgesia 5(11):p 1914-1921, November-December 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.21

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Abstract

  Context: Dexmedetomidine is an alpha 2 receptor agonist with sympatholytic, analgesic and sedative effects. This study was designed to study the anaesthetic sparing effect of dexmedetomidine and to compare the efficacy of dexmedetomidine with fentanyl. Aims: 1) to study the effect of dexmedetomidine and compare dexmedetomidine with fentanyl in patients undergoing ENT surgeries. Methods and Material: After approval from institutional ethical committee a prospective randomized controlled study was conducted in forty ASA class 1 and 2 patients posted for ENT surgeries. Patients were randomly divided into two groups. Dexmedetomidine group received a bolus dose of 1mcg/kg body weight over ten minutes followed by infusion at the rate  of 0.4mcg/kg/minute. Fentanyl group patients received 2mcg/kg fentanyl five minutes before the induction. Haemodynamic parameters were measured at specific end points. The anaesthetic and analgesic requirement was noted. Statistical analysis used: Data was analysed using computer statistical software system openepi. The unpaired t­test was used for intergroup comparisons except where specified. Probability values p < 0.05 were considered significant and p < 0.001 were considered highly significant. Results: It was noted that there was no significant difference haemodynamic parameters and quality of surgical field. The average sevoflurane during the first hour of surgery was significantly lower in group D. The incidence of post­operative nausea and
vomiting was significantly lower in group F. Conclusions: Dexmedetomidine used in the dose of 1mcg/kg IV bolus followed by 0.4mcg/kg/hour provides effective and well tolerated alternative to fentanyl in reducing the requirement of analgesic and anaesthetic agents. 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.51118.21

Keywords

Dexmedetomidine; Fentanyl; Anaesthetic Sparing Effect; Hypotensive Anaesthesia.

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