Dexmedetomidine, morphine, propofol vs midazolam, morphine, propofol for conscious sedation in rhinoplasty under local anesthesia. A prospective, randomized study

Ragab, Ashraf; Shamaa, Hossam El; Ibrahim, Mohamed

doi:10.1016/j.egja.2013.01.003

Cited by 6 publications

(5 citation statements)

References 17 publications

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“…Midazolam is commonly used as a sedative for sinonasal surgery performed under local anaesthesia. There have been two randomised trials comparing midazolam with dexmedetomidine 27 , 28 . Although the aim was to investigate the sedative effect, dexmedetomidine was shown by these two studies to have decreased intra-operative bleeding and improve the operative field quality as a result of the hemodynamic stability it produced.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review

et al. 2015

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Section: Discussionmentioning

confidence: 99%

Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review

et al. 2015

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“…Jouybar et al discovered that patients administered dexmedetomidine during anesthesia experienced significantly greater surgical satisfaction, attributed to a reduced amount of bleeding [ 6 ]. Another study found that using dexmedetomidine instead of midazolam alongside morphine and propofol resulted in shorter surgery times, lower pain scores, and increased patient and surgical satisfaction [ 47 ]. However, this study found no significant difference in surgical satisfaction and the quality of the surgical field.…”

Section: Discussionmentioning

confidence: 99%

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis

Janipour,

Bastaninejad,

mohebbi

et al. 2024

BMC Anesthesiol

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Background Nasal surgeries, addressing anatomical variations for form and function, require careful anesthesia administration, including dexmedetomidine and remifentanil. This meta-analysis evaluates their safety and efficacy variations in nasal surgeries, emphasizing patient comfort and optimal outcomes. Methods Four electronic databases (PubMed, Scopus, Web of Science, and CINAHL Complete) were searched for records in English. Studies that measure the effect of dexmedetomidine versus remifentanil on patients underwent nasal surgery were included. The Cochrane Collaboration’s tool was used to assess the quality of the included studies. A random-effect model was preferred and statistical analysis was performed by Stata software version 17. Results Out of an initial pool of 63 articles, five studies were selected for this analysis. All of these chosen studies were Randomized Controlled Trials (RCTs). The meta-analysis involved a total of 302 participants, with 152 in the remifentanil group and 150 in the dexmedetomidine group. The analysis aimed to compare the effects of Dexmedetomidine and Remifentanil on heart rate (HR) and mean arterial pressure (MAP) during surgery. Both groups exhibited similar MAP and HR, with the exception of a slightly lower HR in the remifentanil group at the 15th minute of surgery (Standardized Mean Difference: -0.24 [-0.83, 0.34]). Furthermore, when evaluating the impact of these medications on post-surgery outcomes, including pain levels, the use of pain relief medications, patient-surgeon satisfaction, agitation scores, and recovery time, no significant differences were observed between the two medications in any of these aspects. Conclusion In summary, the study compared Dexmedetomidine and Remifentanil in nasal surgeries anesthesia. No significant differences were found in heart rate, blood pressure, satisfaction, pain, agitation, or recovery time. The study had limitations, and future research should establish standardized protocols and consider various surgical factors.

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“…[12] This provides sympathetic inhibition in the central nervous system, which leads to a reduction in blood pressure, HR, sedation, decreased arousal, analgesic effect, and anxiolysis. [41213]…”

Section: Discussionmentioning

confidence: 99%

“…Intraoperative mean arterial blood pressure and HR in dexmedetomidine were lower than their baseline values and the corresponding values in midazolam. [413]…”

Section: Discussionmentioning

confidence: 99%

Comparision of vital surgical parameters, after administration of midazolam and dexmedetomidine for conscious sedation in minor oral surgery

Sivasubramani

Pandyan

Ravindran

2019

Ann Maxillofac Surg

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Aim:The aim of this study is to compare the efficacy between midazolam and dexmedetomidine in relation to vital parameters, sedation score, pain score, cognitive judgment, and postoperative amnesia to the event in conscious sedation for minor oral surgical procedure.Materials and Methods:A sample size of 30 patients were selected in each group: Group M (midazolam) and Group D (dexmedetomidine).Results:The mean heart rate (HR) and systolic and diastolic blood pressure measurements were significantly higher in Group M after the 20th min when compared to Group D. The visual analog scale (VAS) scores of pain were not statistically significant between the two groups during the procedure, but at the time of discharge, statistically significant VAS scores were found between the two groups. Nine (30%) patients in Group D and 21 (70%) patients in Group M showed cognitive judgment impairment with the Stroop Color and Word Test at the 30th min.Conclusion:The dexmedetomidine group of patients had reduced blood pressure and HR. No significant differences were noted in oxygen saturation or in respiratory rate between the two drugs. Patients had better sedation, analgesia, lesser cognitive impairment, and amnesia in the dexmedetomidine group.

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Dexmedetomidine, morphine, propofol vs midazolam, morphine, propofol for conscious sedation in rhinoplasty under local anesthesia. A prospective, randomized study

Cited by 6 publications

References 17 publications

Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review

Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review

Dexmedetomidine versus remifentanil in nasal surgery: a systematic review and meta-analysis

Comparision of vital surgical parameters, after administration of midazolam and dexmedetomidine for conscious sedation in minor oral surgery

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