Dexmedetomedine vs midazolam sedation in middle ear surgery under local anesthesia: Effect on surgical field and patient satisfaction

Evaluation of the merits of two drugs-dexmedetomidine and ketamine for day care hysteroscopic procedures

“…So our results were similar to Abdellatif et al, Ghali et al, Arain and Ebert, Takimoto et al, which proved the sedation safety and reduced adverse effects of dexmedetomidine. [18][19][20][21] In our study, the dose of dexmedetomidine to induce sedation in patients who underwent anaesthesia was used in the range of those used in other studies. [22][23][24] Verma R et al, in 2014 have demonstrated that dexM provides adequate levels of sedation without clinically significant respiratory depression in the perioperative period and observed that rescue analgesia as injection fentanyl was required in less number of patients in dexM group that explains the analgesic property of the drug, which is consistent with the findings of Arain and Ebert.…”

Patient satisfaction in middle ear surgery under monitored anaesthesia care

“…This was a single centered retrospective study 6,7 In our study, we used monitored anaesthesia care as many other authors. 4,5,9,10 Parikh D et al compared dexmedetomidine bolus followed by infusion with injection midazolam plus fentanyl bolus followed by normal saline infusion to evaluate patient satisfaction score and effectiveness of analgesia and sedation. 9 Abdellatif et al compared dexmedetomidine infusion with midazolam infusion for sedation in middle ear surgery under local anaesthesia to see effect on surgical field and patient satisfaction.…”

“…9 Abdellatif et al compared dexmedetomidine infusion with midazolam infusion for sedation in middle ear surgery under local anaesthesia to see effect on surgical field and patient satisfaction. 4 However, we used injection midazolam 0.02 mg/ kg and fentanyl 1 mcg/kg bolus initially prior to local anaesthetic injection, followed by injection fentanyl 0.5 mcg/kg if required. The overall patient satisfaction was 79.7% in our study which is similar to study done by Parajuli et al where they have used injection meperidine and promethazine intramuscular 45 minutes prior to local anaesthetic infiltration.…”

“…7 Abdellatif et al and Parikh D et al have shown better patient satisfaction with dexmedetomidine group rather than midazolam alone or midazolam-fentanyl group. 4,9 Dexmedetomodine along with its analgesic property has been shown to be an effective baseline sedative for MAC for a broad range of surgical procedures providing better patient satisfaction, less respiratory depression and opioid requirement. 11 Due to cost concern and unavailability we were not able to use dexmedetomidine as a sedative agent which would probably have increased patient satisfaction in our study as well.…”

“…Some have conducted it as a part of monitored anaesthesia care while others as conscious sedation. [4][5][6][7] Middle ear surgeries were being performed under local anaesthesia as it was considered to have several advantages over general anaesthesia like unavailability of trained anaesthesiologist, lack of adequate or functional anaesthesia equipment, prolonged recovery time, cost and morbidity of general anaesthesia. 8 The rationale of conducting this study was to evaluate patient satisfaction during middle ear surgeries performed under monitored anaesthesia care.…”