A Comparison Between Dexmedetomidine Infusion and Propofol Infusion as an Adjuvant to Local Anaesthesia in Patients Undergoing Tympanoplasty Surgeries

BACKGROUND objectives of this study was to compare effects of dexmedetomidine infusion and propofol infusion in patients undergoing surgeries under local anaesthesia. Propofol is commonly used in various surgeries, it causes hypnosis, sedation, , antiemetic action but has disadvantages like apnoea, myocardial depression. Dexmedetomidine is a newer drug it sedation, analgesia, decreased sympathetic activity and minimal respiratory depression. The primary aim is to compare effects of dexmedetomidine infusion versus propofol infusion as an adjuvant to local anaesthesia on patient’s sedation, and respiratory function, patients and surgeons comfort and postoperative recovery. AND METHODS 100 Cases of 18-50 years age of ASA status I-II undergoing tympanoplasty surgeries were allocated into 2 groups. All cases premedicated with Inj. glyco 10 mcg/kg IV & Inj. Diclofenac 75 mg IM 30 min before operative procedure. Group D received dexmedetomidine 1 µg/kg i.v.as initial dose over 20 minutes using an syringe pump, and followed by maintenance infusion of dexmedetomidine at a constant rate of 0.4 µg/kg/h and titrated, if at all necessary to any adverse events. In group P, an initial dose of 1 mg/kg of propofol (1% preparation contains: 10 mg/ml propofol) infused I.V. over 20 minutes, followed by a maintenance infusion of 30 µg/kg/min. The maintenance infusion in both the was commenced immediately, once the initial dose infusions were stopped. Sedation level was measured by Ramsay Scale, haemodynamic parameters for every 15min intra operatively. Patient and surgeon satisfaction scores and also -operatively Modified Aldrete Scoring was assessed for each patient after 30 minutes of the end of each operation. compared between dexmedetomidine and propofol groups both provide good surgeon satisfaction while group D better satisfaction, When group P is compared with group D the degree of sedation was more in P group during observations of 15 minutes, 30 minutes, 45 minutes and 75 minutes of intraoperative periods but in rest of the times the differences not statistically significant, And there is also no statistically significant difference in haemodynamic parameters and function. of dexmedetomidine (I.V.) with an initial loading dose of 1 mcg/kg over 20 minutes and followed by an infusion at the of 0.4 mcg/kg/hr provides adequate sedation and significantly better patient satisfaction in tympanoplasty surgeries, with significant alteration of hemodynamic and respiratory parameters in monitored anaesthesia care