Abstract Objective: To compare the efficacy of dexmedetomidine as a hypotensive agent with esmolol in elective ENT Surgeries in ASA grade III patients. Methods: This study was a prospective, randomized, double blinded study that included 60 ASA grade I and II patients, undergoing ENT surgeries 30 patients in each group. They were allocated to receive either esmolol (Group E) or dexmedetomidine (Group D) to maintain mean arterial blood pressure (MAP) between (5565 mmHg). Intraoperative analgesic and additional hypotensive agent requirements were recorded. Standard Average Category Scale (ACS) was used for assessment of blood loss intraoperatively. Hemodynamic variables, emergence time, postoperative recovery time and sedation score following tracheal extubation were recorded. Postoperative pain, nausea and vomiting score and time needed to first analgesic were also recorded. Independent student T test was used for comparision of continuous variables and Chi square test for categorical variables. A P value of < 0.05 was considered statistically significant. Result: There were no inter group differences in haemodynamics and ACS. Emergence time, postoperative recovery and sedation score were significantly higher in Group D. VAS score was significantly lower in Group D. Time to first analgesic request was significantly longer in Group D. No postoperative nausea or vomiting was observed in both groups. Conclusion: Both dexmedetomidine and esmolol were effective in providing ideal surgical field. Both were safe agents for controlled hypotension. Dexmedetomidine offers the advantage of analgesia, amnesia and sedation with better intraoperative and postoperative patient satisfaction as compared to esmolol.
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