Comparison of Dexmedetomidine With Fentanyl for Sedation in Tympanoplasty (Ent Surgeries) Done Under Monitored Anaesthesia Care

Abstract

INTRODUCTION Monitored anaesthesia care involves administering a combination of drugs for anxiolytic, hypnotic, amnestic and analgesic effect. Ideally it should result in less physiological disturbance and allow for more rapid recovery than general anaesthesia. It typically involves administration of local anaesthesia in combination with IV sedatives, anxiolytic and analgesic drugs which is a common practice during various ENT surgical procedures. AIM OF STUDY Is to "Compare Dexmedetomidine with Fentanyl for sedation in tympanoplasty (ENT Surgeries)". The objective of the study is to evaluate the efficacy of dexmedetomidine and fentanyl as an appropriate sedative drug for Monitored Anaesthesia Care in Tympanoplasty (ENT surgeries) METHODS & MATERIALS A total of 60 patients are being recruited into this study with regards to assess, Pain, Discomfort, Sedation, Peripheral Oxygen Saturation (SPO2) & Systolic Blood Pressure (SBP), Diastolic blood pressure (DBP), Mean arterial blood pressure(MAP) & Heart rate This study was undertaken at Govt. ENT Hospital Hyderabad. Sixty (60) patients undergoing Tympanoplasty surgery were taken for study. Thus the study contains 30 patients in Dexmedetomidine group-(Group D) and 30 patients in Fentanyl group (Group F) RESULT Dexmedetomidine provides less discomfort, better sedation, and analgesia when compared with fentanyl under monitored anaesthesia care (Conscious sedation). However, the risk of adverse effects requires monitoring for ready intervention. It provides a unique type of sedation, "conscious sedation" in which patients appear to be sleepy but are easily arousable, cooperative and communicative when stimulated. It is sedative and analgesic agent, with opioid-sparing properties and minimal respiratory depression.

A prospective randomized double blind study to compare the effects of dexmedetomidine and fentanyl on intubating conditions during awake fiberoptic bronchoscopy guided intubation

“…The dexmedetomidine provides a unique form of sedation in which patients remained arousable (conscious sedation) even at deeper levels of sedation which is a desirable feature of dexmedetomidine. 2,3,12,16,[23][24][25][26] No significant difference in HR and MAP was noted in dexmedetomidine group but in fentanyl group there was significant, though clinically acceptable increase was noted just after intubation which favours the dexmedetomidine's property of maintaining stable haemodynamics.…”