Comparative study between dexmedetomidine/nalbuphine and midazolam/nalbuphine in monitored anesthesia care during ear surgery

Abstract

Background: Monitored anesthesia care (MAC) is the practice of administrating local anesthesia in combination with IV sedatives, anxiolytics and/or analgesic drugs during certain surgical procedures. Most of ear surgeries can be done under monitored anesthesia care. Methodology: This is a randomized, double blind, prospective study and 100 patients undergoing ear surgery under MAC were divided into two groups of 50 patients each. The patients in group (D) received dexmedetomidine 1 lg/kg IV over 10 min followed by 0.7 lg/kg/h + nalbuphine 100 lg/kg IV and in group (M) received midazolam 20 lg/kg IV followed by 20 lg/kg/h + nalbuphine 100 lg/ kg over 10 min. Assessment of sedation by Ramsay sedation score, requirement of intraoperative rescue sedation, intraoperative VAS, intraoperative rescue analgesia, intraoperative hemodynamics, intraoperative bleeding, intraoperative complications, postoperative visual analogue score and postoperative rescue analgesia requirement, time to achieve full recovery and satisfaction scores of patients and surgeon were recorded. Results: Group (D) showed more sedation by Ramsay sedation score than the midazolam (M) group. Fifty percent in group (M) needed more rescue sedation than 26% in group (D) (p < 0.05). Intraoperative VAS was significantly higher in group (M) than in group (D) that led to the use of more rescue analgesia in 60% of group (M). Intraoperative heart rate and mean blood pressure were significantly lower in group (D) than in group (M) (p < 0.05). There was no statistical difference between the two groups as regards respiratory rate or SpO 2 . Intraoperative bleeding is less significantly less in group

Comparative study of dexmedetomidine versus midazolam in monitored anaesthesia care in tympanoplasty surgery

“…The mean RSS was significantly higher at almost all-time intervals in group D, implies that the level of sedation was found to be significantly better with dexmedetomidine. This result correlated well with the study done by Parikh et al [4] and Mohamed et al [15] The rescue sedation with propofol was required for one patient in group D and 4 patients in group M, but it was not statistically significant. The sedative effect of dexmedetomidine and midazolam was comparable at the end of loading dose, at 10 minutes and also after 30 min till the end of surgery.…”

Monitored anaesthesia care – Comparison of nalbuphine/dexmedetomidine versus nalbuphine/propofol for middle ear surgeries: A double-blind randomised trial

“…Power analysis was based on the results of a previous study. [ 9 ] Sample size calculation was based on a population standard deviation of 1.1 with 80% power and 5% alpha error. To detect a difference in sedation score of one between groups, a sample size of 43 patients per group was required.…”

“…Based on a previous study, we hypothesised that nalbuphine/dexmedetomidine combination provides better sedation and analgesia than nalbuphine/propofol combination in monitored anaesthesia care. [ 9 ] In the present study, we compare the effect of nalbuphine/dexmedetomidine combination with nalbuphine/propofol on sedation and analgesia in monitored anaesthesia care.…”

Comparative Evaluation of the Intranasal Spray Formulation of Midazolam and Dexmedetomidine in Patients Undergoing Surgical Removal of Impacted Mandibular Third Molars: A Split Mouth Prospective Study

“…Moreover, establishing an intravenous access is painful and frightening for many patients. According to numerous studies, the use of intranasal medications for sedation during dental procedures is easy, effective, and associated with safety issues [1][2][3][4][5][6][7][8][9][10].…”