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A Study of Dexmedetomidine Compared with Midazolam for Sedation in Endoscopic Dacryocystorhinostomy
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Purpose: The objective of this study were to study the efficacy of dexmedetomidine as a sedative for endoscopic dacryocystorhinostomy performed under local anaesthesia compared to conventional sedative like midazolam and also to study the effects of dexmedetomidine on hemodynamic stability and analgesia.
Methods: In this randomized,prospective double-blinded study 40 adult patients were allocated into two groups.Group D received dexmedetomidine 1μg/kg loading dose over 10 minutes followed by 0.5 μg/kg/hr maintenance dose and Group M received 20 μg/kg midazolam at the start of procedure plus same dose repeated 30 minutes later. Endoscopic dacryocystorhinostomy was performed in all patients under local anesthesia. Sedation was assessed using the modified Observer's Assessment Alertness/ Sedation (OAA/S) scale. Pulse rate(PR), Mean arterial pressure(MAP),oxygen saturation (SpO 2), respiratory rate (RR) were recorded every 5 minutes for first fifteen minute and then every ten minutes till the end of the procedure.In the post anaesthesia care unit,Aldrete score was determined every 5 minutes till the patient was ready for discharge.
Results: Pateints receiving dexmedetomidine had a better OAA/S score throughout the procedure and were more cooperative. VAS scores were significantly lower in the dexmedetomidine group.Pulse rate, MAP were lower in Group D whereas SpO 2 values were higher in Group D compared to Group M. Group D had lesser amount of bleeding but the time taken to reach an Aldrete score of 10 was similar between the groups.
Conclusion: Dexmedetomidine is ideal for procedural sedation with the added benefit of hemodynamic stability, no respiratory depression and analgesia.
Keywords
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