---

Comparative Evaluation of IV Dexmedetomidine versus Dexmedetomidine with Butorphanol as an Adjuvant for Monitored Anaesthesia Care in Tympanoplasty and Myringoplasty: A Prospective, Controlled, Ran

Full Text PDF

---

Original Article

Author Details : Alka Kewalramani(Chhabra), S. S. Jaitawat, Sunanda Gupta, Shashank Gupta

Volume : 3, Issue : 1, Year : 2016

Article Page : 96-101

Suggest article by email

Get Permission

Abstract

Background and Aims: It is a common practice to perform procedures like Tympanoplasty and Myringoplasty under Monitored Anaesthesia care (MAC). The recently introduced selective ?₂ agonist dexmedetomidine, known for its opioid sparing effect along with sedative, analgesic  hypotensive and anaesthetic properties with minimal respiratory depression has been used as a sole agent to provide MAC in various surgical interventions. The present study is aimed to evaluate the role of Dexmedetomidine as a sole sedoanalgesic agent and compare the efficacy of adding an adjuvant like Butorphanol to Dexmedetomidine.
Material & Methods: 60 patients of either sex, aged 18-20 years, ASA grade I&II  were randomized into two groups(D and BD) of 30 patients each for microscopic ear surgery under Local Anaesthesia(LA) with MAC. Group D received inj. Dexmedetomidine 1 mcg/kg iv loading dose while Group BD received inj. Dexmedetomidine 1 mcg/kg iv loading dose along with inj. Butorphanol 0.02 mg/kg. Both groups received an infusion of inj. Dexemetomidine @ 0.2 mcg/kg/hr. All patients were assessed for intraoperative haemodynamic changes, SpO₂, respiratory rate, Ramsay sedation score(RSS), and visual analogue scale(VAS).Rescue doses of sedatives, analgesics, satisfaction scores(Patients and Surgeons) were compared in both the groups. Data was analyzed using chi-square and t-test.  p value <0.05 was considered significant.
Results: Mean Heart Rate (HR) and Mean Arterial Pressure (MAP) were significantly decreased from baseline in group BD as compared to group D (p<0.001). RSS, in group BD was significantly higher as compared to group D throughout the surgery. Rescue sedation was given in 3 patients in group BD while in group D, 9 patients required additional sedation (p<0.01) .Rescue analgesic with iv fentanyl was administered in 27 patients and 6 patients respectively in groups D and BD.Patient and surgeon satisfaction scores were also  significantly higher in group BD vs group D (p<0.001).
Conclusion: A combination of Dexmedetomidine with Butorphanol as an adjuvant for Monitored Anaesthesia Care in microscopic ear surgery was found to provide superior sedoanalgesia.

Key Words: Monitored Anaesthesia Care, Dexmedetomidine, Butorphanol, Middle ear surgery

How to cite : Kewalramani(chhabra) A, Jaitawat S S, Gupta S, Gupta S, Comparative Evaluation of IV Dexmedetomidine versus Dexmedetomidine with Butorphanol as an Adjuvant for Monitored Anaesthesia Care in Tympanoplasty and Myringoplasty: A Prospective, Controlled, Ran. Indian J Clin Anaesth 2016;3(1):96-101

This is an Open Access (OA) journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms.