Dexmedetomidine causes prolonged recovery when compared with midazolam/fentanyl combination in outpatient shock wave lithotripsy

Abstract

Dexmedetomidine was associated with a longer recovery time than a midazolam/fentanyl combination when used for sedation and analgesia during outpatient extracorporeal shock wave lithotripsy in this study. The incidence of rescue sedative and analgesic need was also significantly higher when dexmedetomidine was used.

A prospective randomized double blind study to compare dexmedetomidine and midazolam in ear nose and throat surgery for monitored anesthesia care

“…9,11,16,17 However, Zeyneloglu et al have reported better satisfaction scores with midazolam-fentanyl combination as compared to dexmedetomidine in extracorporeal shock wave lithotripsy (ESWL) when used alone. 18 The authors also concluded that probably it was not effective as a sole agent in ESWL. In our study in spite of higher satisfaction scores in the dexmedetomidine group, both the drugs were comparable in terms of sedation as none of the patients in either group required additional sedation with propofol or any alternative anesthesia technique.…”

Comparison of Hypotension Caused By Dexmedetomidine– Fentanyl Combination with that of Midazolam–Fentanyl Combination in Hypertensive Patients Undergoing Tympanoplasty Surgery under MAC

“…[24,[31][32][33][34] The low heart rate and MAP was maintained for longer duration in group D compared to that of group M which can be explained by longer duration of action of dexmedetomidine, [24,30] as compared to that of midazolam. [18,26] These results suggest that dexmedetomidine has clinical advantage over midazolam in providing a better operative field for microscopic surgery and therefore better surgeon satisfaction. Over sedation leading to respiratory depression is an important complication during MAC.…”

“…Commonly, midazolam is given in combination with fentanyl in MAC. [16][17][18][19][20] This combination has the advantage of potentiating both hypotensive and sedative effect. It has minimal effect on heart rate as midazolam causes mild tachycardia and fentanyl causes mild bradycardia.…”

“…[16,19,20,22,23] This proves that dexmedetomidine is a better sedative agent compared to that of midazolam and its duration of action is longer than that of midazolam. [18] In the present study, all patients were administered an antiemetic ondansetron before surgery to overcome the emetic effect of fentanyl. [25] Therefore, there was no incidence of intraoperative and post-operative nausea-vomiting in both the groups.…”

“…This technique is called Monitored Anaesthesia Care (MAC). [12] Medications commonly used for MAC include Ketamine, [13] Propofol, [14,15] Pentazocine, [16] combination of Midazolam-Fentanyl, [16][17][18][19][20] Midazolam as single agent, [21][22][23] Dexmedetomidine as a single agent and combination of Dexmedetomidine-Fentanyl. [20] Combination of Dexmedetomidine with Fentanyl leads to potentiation of all actions of Dexmedetomidine resulting in excellent hypotension, sedation and analgesia during the intraoperative period.…”