Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures

Abstract

Objectives: To compare the sedative effects of dexmedetomidine alfentanil versus ketamine-alfentanil in patients undergoing closed reduction of nasal fractures on the basis of intraoperative hemodynamic changes, satisfaction of patients and surgeons, and the adverse effects. Methods: Sixty patients with ASA class 1 or 2 were randomized to either of two groups, a dexmedetomidine alfentanil group (DA group; n = 30) or a ketamine-alfentanil group (KA group; n = 30). Hemodynamic parameters, oxygenation status, adverse events, the satisfaction of patients and surgeons, and postoperative pain scores by visual analog scale (VAS) were recorded at specific time intervals during the trial. Results: Systolic blood pressure was significantly lower in the DA group than in the KA group from T1 min to T15 min. The duration of the recovery ward stay was longer in the DA group; however, two groups were similar in terms of total anesthesia time and awakening time. Likewise, two groups were similar in terms of the patient and surgeon’s satisfaction, pain scores, and the occurrence of adverse effects. Conclusions: Both sedation methods were safely performed, and dexmedetomidine-alfentanil is as effective as ketamine-alfentanil in patients undergoing short-term operations such as nasal fracture corrections.

To Compare the Efficacy of Dexmedetomidine Versus Labetalol in Providing Controlled Hypotension in Functional Endoscopic Sinus Surgery

“…Although we did not achieve controlled hypotension during the entire surgery in the study, according to the findings, the mean arterial pressure values were lower in group D than in group L from the 20th minute of induction. Besides, the heart rate was lower in group D than group L, and its trend was significantly lower in group D. Dexmedetomidine is a selective α 2 agonist that is known for its sedative, analgesic, and anesthetic sparing properties (7,8,11). In the present study, the abovementioned actions may have contributed to better perioperative hemodynamic stability and surgical field visibility in patients who receive dexmedetomidine.…”

“…Several pharmacological agents are developed to control hypotension, including remifentanil (3), magnesium sulphate (4), nitroglycerine (5), esmolol (5), and dexmedetomidine (5). The effect of dexmedetomidine on controlling hypotension is well known and is compared with other agents like remifentanil (3), magnesium sulphate (4), esmolol (5), clonidine (6), and fentanyl (7,8). Our institute has a history of providing FESS to normotensive patients under general anesthesia.…”

Practical Considerations for Dexmedetomidine Sedation in Adult Cataract Surgery Under Local/Regional Anesthesia: A Narrative Review

“…tion, dexmedetomidine has also been used for sedation during awake fibreoptic intubation (16), reducing emergence delirium in children for strabismus surgery (17), premedicating children undergoing dental procedures (18), reducing the hemodynamic changes during elective colonoscopy (19), improving post-cesarean analgesia (20), sedating patients for closed reduction of nasal fractures (21), providing controlled hypotension during functional endoscopic sinus surgery (22), and reducing postoperative cognitive dysfunction (POCD) after middle ear surgery under hypotensive technique (23). Dexmedetomidine has also been used more importantly as an adjuvant to improve chronic and neuropathic pain and prolong the effects of chronic pain procedures (24).…”

The Effect of Pneumoperitoneum-induced Hypertension During Laparoscopic Cholecystectomy Under General Anesthesia on Postoperative Pain: A Randomized Clinical Trial

“…Non-steroid anti-inflammatory drugs (NSAIDs) and opioids administration have been shown to be effective in controlling pain in perioperative period; however, there are some concerns about their side effects (13)(14)(15)(16)(17). Therefore, adjuvant drugs such as ketamine and dexmedetomidine can play a special role in this regard (18)(19)(20)(21).…”