A comparison of effects of dexmedetomidine versus midazolam-fentanyl on post-operative recovery, sedation, analgesia and hemodynamic parameters in patients undergoing middle ear surgery under local anesthesia

Authors

  • Dr. Abhinav Goyal Post Graduate, Department of Pharmacology, B P S GMC for Women, Khanpur Kalan, Sonipat, Haryana https://orcid.org/0000-0002-9256-2515
  • Dr. Garima Bhutani Professor, Department of Pharmacology, BPS GMC(W), Khanpur kalan, Sonepat, Haryana
  • Dr. Meena Singh Associate Professor, Department of Anesthesia, BPS GMC(W), Khanpur Kalan, Sonepat, Haryana https://orcid.org/0000-0003-2844-9849
  • Dr. Naveen Sharma Associate Professor, Department of otorhinolaryngology, BPS GMC(W), Khanpur Kalan, Sonepat, Haryana
  • Dr. Seema Rani Professor & HOD, Department of Pharmacology, BPS GMC(W), Khanpur Kalan, Sonepat, Haryana
  • Dr. Rahul Saini associate Professor, Department of Pharmacology, BPS GMC(W), Khanpur kalan, Sonepat, Haryana https://orcid.org/0000-0001-9623-8248
  • Dr. Mohd Fazal Ahmed Makki Post Graduate, Department of Pharmacology, BPS GMC(W), Khanpur kalan, Sonepat, Haryana https://orcid.org/0000-0002-0097-0248

Keywords:

Analgesia, Dexmedetomidine, Fentanyl, Hemodynamic parameters, Midazolam, Middle ear surgery, Recovery, Sedation

Abstract

Background

Middle ear surgeries are usually done under local anesthesia with sedation to make surgery very comfortable for the patient, anesthesiologist and the surgeon. An ideal sedative agent should be fast acting, have less impact on normal physiological and physical functions and produce faster recovery with lesser side effects. In search of a better sedative agent we conducted this study comparing Dexmedetomidine versus midazolam and fentanyl combination.

Materials and Methods

72 patients were randomly divided into two equal groups - Group D (dexmedetomidine) and Group MF (midazolam & fentanyl). Intra operative heart rate, mean blood pressure, respiratory rate, and SPO2 were recorded every 15 minutes for the 1st 30 minutes and then at every 30 minutes interval till the end of the surgery. In post-operative period, hemodynamic parameters, Aldrete score & pain were assessed at every 30 minutes till the patient was discharged from PACU. Post-operative sedation of the patient was checked at 1 hour, 2 hour, 4 hour and 8 hours.

Observations

Midazolam & fentanyl combination caused more fall in Aldrete scores as compared to dexmedetomidine initially, but readiness to discharge from PACU was similar in both the groups. Patients of MF group had significantly higher sedation scores at post op 2 hours, but overall duration of sedation was similar in both the groups. Post-op pain was significantly more in MF group patients, as compared to dexmedetomidine patients at 1.5 hours. More number of patients of MF group demanded rescue analgesia in PACU. Both group of drugs caused similar changes in hemodynamic parameters during surgery but in post-op period, dexmedetomidine produced less decline in respiratory rate and oxygen saturation as compared to midazolam and fentanyl combination.

Conclusion

The present study concluded that dexmedetomidine seems to be a better alternative to the combination of midazolam plus fentanyl sedation for patients undergoing middle ear surgeries done under local anesthesia due to better analgesia & lesser derangement of haemodynamic parameters in post-operative period.

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Published

18-07-2022

How to Cite

Abhinav Goyal, Garima Bhutani, Meena Singh, Naveen Sharma, Seema Rani, Rahul Saini, and Mohd Fazal Ahmed Makki. “A Comparison of Effects of Dexmedetomidine Versus Midazolam-Fentanyl on Post-Operative Recovery, Sedation, Analgesia and Hemodynamic Parameters in Patients Undergoing Middle Ear Surgery under Local Anesthesia”. Asian Journal of Pharmaceutical and Clinical Research, vol. 15, no. 10, July 2022, https://innovareacademics.in/journals/index.php/ajpcr/article/view/45462.

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Original Article(s)