Vol. 5, Issue 3, Part D (2019)

Analgesia and sedation are usually required for the comfort of all patients and surgeons during any surgery, particularly ENT surgery done under local anesthesia.

We conducted a prospective randomized study on 60 adult ASA grade I/II patients of either sex posted for various elective ENT surgeries under LA and monitored anesthesia care. They were randomly divided in to two equal groups as follows.

Group D: received IV dexmedetomidine infusion of 1mcg/kg over 10 min followed by 0.2mcg/kg/h during surgery.

Group MF: received IV midazolam 0.06mg/kg and IV fentanyl 1mcg/kg over 10 min followed by normal saline infusion at 2 ml/kg/h.

Sedation was maintained to keep Ramsay Sedation Score (RSS) to 3. Surgery was performed under LA. Intra operatively, if required, patients were given rescue analgesic fentanyl1mcg/kg and rescue sedative midazolam 0.01mg/kg. Patients’ vital parameters (PR, BP, SPO2, ECG), VAS and sedation scores were recorded every 10 min. postoperatively all patients were interviewed to assess their satisfaction score about the technique. Surgeons were also asked for their opinion to assess their satisfaction about sedation technique.

We found that:

•Surgeons’ and patients’ satisfaction score were better in Group D than Group MF (9 and 7.5, and 9 and 8 respectively).

•Intraoperative pulse rate and BP were lower in Group D than in Group MF.

•In group D 8 patients required rescue LA infiltration. In group MF 12 patients required rescue LA infiltration.

•Number of patients requiring rescue analgesic and rescue sedative medication was higher in MF group than in group D (8 and 4, and 4 and 1 patient respectively).

None of the patients in both the groups had any complications requiring active treatment.