Dexmedetomidine used to provide hypotensive anesthesia during middle ear surgery

Abstract

This study was carried out to assess the hypotensive effect of low dose dexmedetomidine (DEX) infusion during middle ear surgery. 42 ASA grades I and II patients of either sex aged 18-45 years undergoing elective middle ear surgery were randomly divided into two groups of 21 each. Group I received placebo bolus and infusion of saline at a rate similar to DEX in Group II. Group II received 10-15 min prior to induction of anesthesia 1 μg/kg IV bolus DEX diluted in 10 ml of normal saline over 10 min. Immediately thereafter an infusion of 0.4 μg/kg/hr of DEX commenced. Standard anesthetic technique was used. Halothane was titrated to achieve a mean arterial pressure 30% below the control value (value taken just after premedication). We observed that a statistically signifi cant reduction in the percentage of halothane required to reduce MAP 30% below control value occurred in patients receiving DEX infusion (1.3 ± 0.4%) in comparison to those receiving placebo (3.1 ± 0.3%). Patients receiving DEX infusion had a better surgical fi eld. The mean awakening time was signifi cantly reduced in patients of Group II (9.1 ± 2.7 min) when compared to patients of Group I (12.8 ± 2.2 min).We conclude that DEX can be safely used to provide hypotensive anesthesia during middle ear surgery.

Controlled Hypotensive Anaesthesia With Dexmedetomidine for Functional Endoscopic Sinus Surgery: A Prospective Randomized Double Blind Study

“…A controlled trial conducted by Nasreen et al 17 Using low dose dexmedetomidine (0.4 microgram/kg/h) in addition to titrated halothane vol% in order to reduce MAP 30% from the preoperative values during middle ear surgeries, they observed significant reduction in halothane requirement in dexmedetomidine group with better surgical field compared to placebo group.…”

Comparación entre el sulfato de magnesio y la dexmedetomidina en hipotensión controlada durante cirugía funcional endoscópica de los senos paranasales

“…El tiempo hasta alcanzar la puntuación de Aldrete ≥ 9 fue significativamente menor en el grupo D (p = 0,001) (tabla 2). No hubo diferencia con relación a los valores de la ENC en los min 15 …”

“…medio, se relató que la satisfacción del cirujano fue mayor y que la necesidad de agente de inhalación para disminuir la PAM en un 30% disminuyó en el grupo dexmedetomidina 15 . La disminución secundaria de la frecuencia cardíaca y de la PAM, a causa de los efectos inhibitorios de la dexmedetomidina sobre el estímulo simpático central y de la estimulación de los receptores ␣ 2 -adrenérgicos periféricos del músculo liso vascular, fue considerada como responsable de ese resultado.…”

Efficacy of dexmedetomidine infusion as an anesthetic adjuvant to provide oligemic surgical field in middle ear surgeries

“…Reduction of the blood pressure and heart rate decreases bleeding within the surgical field thereby providing bloodless surgical site. 22 Moreover, it has its advantages over other hypotensive anesthetics as it does not cause any respiratory depression. There are still inadequate studies stating the direct effect of Dexmedetomidine on blood vessels and this needs further research.…”