CONSCIOUS SEDATION IN DILATATION AND CURETTAGE: COMPARISON OF IV DEXMEDETOMIDINE VERSUS PROPOFOL

Dr. Rashmi Bengali, Dr Unmesh Bedekar

Abstract


Background: Traditionally propofol has been used for providing sedation in dilatation and curettage (D and C). Recently, dexmedetomidine has been tried in a variety of surgeries, but very little evidence exists to support its use.

 Aims: The aim was to compare hemodynamic , recovery profile and street fitness of both the drugs along with a degree of comfort experienced by patients.

 Materials and Methods: Patients posted for D and C were enrolled in 2 groups (30 each). Both groups received fentanyl 1 μg/kg intravenous (IV) at the beginning of the procedure. Group P received IV propofol in dose of 1 mg/kg over 10 min and Group D received dexmedetomidine at a loading dose of 1 μg/kg over 10 min until Ramsay sedation score reached 3-4. Hemodynamic vitals were compared during and after the procedure. In the recovery room, time to reach modified Aldrete score (MAS) of 8 and patient's and surgeon's satisfaction scores were also recorded and compared.

Results: In Group D, patients had statistically significant lower heart rate at 2, 5, 10 and 15 min as compared to Group P. Hypotension was present more in Group P than Group D (P < 0.05). MAS of 8 was achieved earlier in the dexmeditomedine group (P < 0.05). Group D showed higher patient and surgeon satisfaction scores (P < 0.05).

 Conclusion: Dexmedetomidine provide better hemodynamic and recovery profile than propofol. It can be a superior alternative for short surgical day care procedures. The street fitness of the drug which is a major component for day-care anaesthesia was very well taken care of in the study.


Keywords


Conscious sedation, dexmedetomidine, propofol, dilatation and curettage, sedation

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