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Dexmeditomedine vs Esmolol for Hypotensive Anaesthesia in Oro-Maxillo Facial Surgeries in Tertiary Care Hospital, Kanchipuram District

B. Rajesh, Assistant Professor, Department of Anesthesiology, Karpaga Vinayaga Institute of Medical Sciences & Research Centre, Chinna Kolambakkam, Palayanoor P.O., Kanchipuram District, Madurantagam, Tamil Nadu 603308. , M. Murali Manoj1 , B. Rajesh2

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Indian Journal of Anesthesia and Analgesia 5(7):p 1226-1231, July 2018. | DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5718.22

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Abstract

Introduction: Oro-maxillofacial surgeries are done worldwide. Extensive blood loss is a major concern in these surgeries. To make these procedures uncomplicated we need a good co-operating surgical and anesthesiologist team, very less issue bleeding making surgical field clean and clear. Controlled hypotension1,2 technique is employed or maxilla facial surgeries in which the systolic blood pressure is reduced to 80-90 mm of Hg, mean arterial pressure reduced to 55% to 60% or mean arterial pressure reduced 30% of baseline value.

Aim of the Study: In this study we compared dexmeditomedine and esmolol and their effectiveness and advantage for controlled hypotension in oral-maxillofacial surgeries.

Materials and Methodology: This study was conducted at Karpaga Vinayaga Institute of Medical Sciences and Research Centre as a double-blind randomised control trial involving 50 patients 25 in each group posted for our-maxillofacial surgery. Heart rate and Blood pressure were measured preoperatively, at 15 minutes 30min and 45 min after induction and during surgery, 10 min after infusion drug stoppage, at the end of surgery. After extubation emergence time of both the drugs after surgery was recorded. In both groups sedation scores were measured at 15,30 and 60 min after surgery ended. Intraoperative serum cortisol level were measured in both the groups and recorded separately.

Results: In both groups target mean arterial pressure of 55-60 mm of Hg was achieved. In esmolol group heart rate and blood pressure was higher than dexmeditomedine group at 5 and 10 min. stoppage of study drug and at end of surgery. Dexmeditomedine group showed higher emergence time and sedation score at 15 and 30 min of surgery. There was no difference found intraoperatively in relation to serum cortisol level between the two groups.

Conclusion: The observation in this study shows that dexmeditomedine and esmolol are equally effective in producing controlled hypotension with haemodynamic stability in oro-Castillo facial surgeries. Apart from the above dexmedetomidine has additional advantage of sedation and analgesicsparing effect in compared to esmolol.


 

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DOI: http://dx.doi.org/10.21088/ijaa.2349.8471.5718.22

Keywords

Hypotension; Oro-Maxillofacial Surgeries; Esmolol; Dexmeditomedine.

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