Background and Aims:Middle ear surgeries (MESs) are usually performed under sedation with local anaesthesia and can be well tolerated by the patient with minimal discomfort. In the present study, we compare the effect of nalbuphine/dexmedetomidine combination with nalbuphine/propofol on sedation and analgesia in monitored anaesthesia care.Methods:One hundred adult patients undergoing MESs under monitored anaesthesia care (MAC) were randomly allocated into two groups. All patients in both groups received injection nalbuphine 50 μg/kg intravenously (IV). Group D received a bolus dose of injection dexmedetomidine 1 μg/kg IV over 10 min followed by an infusion started at 0.4 μg/kg/h IV. Group P received a bolus dose of injection propofol 0.75 mg/kg followed by an infusion started at 0.025 mg/kg/min IV. Sedation was titrated to Ramsay Sedation Score (RSS) of 3. Patient's mean arterial pressure, heart rate, saturation peripheral pulse and need for intraoperative rescue sedation/analgesia were recorded and compared. The data analysis was carried out with Z test and Chi-square test.Results:Mean RSS was significantly more in Group D (4.24 ± 1.54) as compared to Group P (2.58 ± 0.95). Overall VAS score was also significantly less in Group D (3.5 ± 1.7) than in Group P (5.4 ± 1.8). In total, 16 patients (32%) in Group D had hypotension whereas 7 patients (14%) only in Group P had hypotension.Conclusion:Nalbuphine/dexmedetomidine combination is superior to nalbuphine/propofol in producing sedation and decreasing VAS in patients undergoing MESs under MAC. Better surgeon and patient satisfaction were observed with nalbuphine/dexmedetomidine. Haemodynamics need to be closely monitored.
Background: Regional epidural anesthesia has been reported to have fewer side effects when compared with general anaesthesia, with comparable surgeon and enhanced patient's satisfaction. Aim: To compare epidural anaesthesia and general anaesthesia in patients undergoing renal surgeries. Methods: Our study included 80 patients who underwent renal surgeries from December 2015 to November 2016. The study subjects were randomly grouped in to 2 groups. Group a included 40 patients and were administered conventional general anaesthesia, while Group B received epidural anaesthesia with 3 mg/kg of ropivacaine and 1 µg/kg of dexmedetomidine. Along with cardio-respiratory parameters, surgeon's satisfaction, patient's satisfaction and side effects were observed and analyzed. Results: Group B showed better patient's satisfaction scores and higher incidence of dry mouth as side effect during the post-operative period. Whereas the side effects of nausea and vomiting were higher in Group A (P < 0.001). Conclusion: Epidural anaesthesia may be safely and effectively used in patients undergoing renal surgeries.
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