Publication:

A comparative study of dexmedetomidine vs midazolam for sedation and hemodynamic changes during tympanoplasty and modified radical mastoidectomy

Background The benzodiazepine, Midazolam, has been used medication given for sedation in tympanoplasty and mastoidectomy because of a number of beneficial effects. However, Dexmedetomidine is a highly selective α2-adrenoceptor agonist is emerging as preferred choice now a day. The aim of the study is to compare hemodynamic stability and sedation under Dexmedetomidine vs Midazolam during tympanoplasty and modified radical mastoidectomy done under local anaesthesia.

Methods After obtaining ethics clearance from institution and written informed consent from patients, 50 patients of age group 15 to 50 years of ASA grade i & ii were selected and divided in to two groups:Group D: Inj. Dexmedetomidine 1µg/kg over 15min, followed by 0.5µg/kg/hr (n= 25).Group M: Inj. Midazolam 0.05 mg/kg i.v. slowly, followed by 0.01mg/kg/hr (n= 25). Arterial blood pressure, heart rate and sedation level were monitored. The surgeons and patients were asked to rate their satisfaction, using the Likert scale.

Results Sedation score difference between group Dand group M was not statistically significant. There was no statistically significant difference found in diastolic blood pressure of both the groups. There was a significant reduction in heart rate in group D as compared to  group M. Surgeon’s satisfaction score and patient’s satisfaction score both were high in group D compare to group M.

Conclusions For monitored anaesthesia care in ENT surgeries performed under local anaesthesia, inj. Dexmedetomidine could be a better alternative over inj. Midazolam.