A RANDOMIZED DOUBLE BLIND STUDY FOR COMPARISION OF DEXMEDETOMIDINE VERSUS CLONIDINE AS A PREMEDICATION FOR OLIGEMIC FIELD IN MIDDILE EAR SURGERY

Dr. Rajiv Gautam, Dr. Shobhit Singh, Dr. L. S. Mishra, Dr. Jitendra Kumar Gupta

Abstract


Aims; The aim of this study was to compare the efficacy of pre operative use of dexmedetomidine and clonidine for producing quality of surgical field visualization during middle ear surgery. Secondary goal was to compare the two agents in regards to satisfaction of surgeon, adverse effects and post op need of analgesia.

Method; This prospective study was conducted on 60 patients of either sex belonging to American Society of Anaesthesiologists (ASA) physical status I-II, aged 18 to 60 years, scheduled for elective microscopic operation in middle ear. Group D : Patient received iv dexmedetomidine 1 mcg/kg diluted in 100 ml saline solution 15 mint before anaesthesia induction. Group C : Patients received iv clonidine 1.5 mcg/kg diluted in 100 ml saline solution 15 min before anaesthesia induction. Isoflurane %was titrated to maintain mean blood pressure around 30% descent in blood pressure. isoflurane percentage was recorded every 15 mint until extubation. bleeding at the surgical field and quality of vision under the operating microscope were evaluated by same surgeon every 15 min in the first hour and then every 30 min according to the intraoperative Surgical field Evaluation (IOSFE) Boezart scale.

Result; Main outcome in this study depends on the IOSFE scale score , which was statistically significantly lower (better quality of vision of the surgical field) in the Group D than in the Group C in all study times. Surgeon's satisfaction score was significantly better in Group D. The amount of blood loss was significantly lower in the Group D (61.86 ± 3.87 ml) than in the Group C (84.7 ± 10.03 ml), At the end of surgery the mean VAS in Group D was significantly lower as compared to Group C at admission, 15, and 30 mint after admission in PACU.

Conclusion; Preinduction bolus dexmedetomidine 1 μg/kg is more effective than bolus clonidine 1.5 μg/kg; for providing controlled hypotension, lesser bleeding at the surgical site and lesser requirement of isoflurane concentration.


Keywords


DEXMEDETOMIDINE, CLONIDINE, EAR SURGERY, American Society of Anaesthesiologists (ASA)

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