A prospective randomized comparative study of dexmedetomidine and propfol for conscious sedation in middle ear surgery under monitored anaesthesia care

2016 ◽  
Vol 3 (2) ◽  
pp. 179
Author(s):  
Leena Goel ◽  
Megha Goel
Keyword(s):  
Comparative Study ◽  
Middle Ear ◽  
Conscious Sedation ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Anaesthesia Care

scholarly journals A Comparative Study of Dexmedetomidine and Propofol for Sedation in Middle Ear Surgery under Monitored Anaesthesia Care at VIMSAR, Burla, Odisha

2021 ◽  
Vol 8 (17) ◽  
pp. 1105-1110
Author(s):  
Pramod Kumar Palai ◽  
Sheela Ekka ◽  
Mahendra Ekka ◽  
Saurabh Agrawal ◽  
Sapan Kumar Jena
Keyword(s):  
Spectral Index ◽  
Middle Ear ◽  
Middle Ear Surgery ◽  
Loading Dose ◽  
Patient Anxiety ◽  
Ear Surgery ◽  
Rescue Analgesia ◽  
Patient’S Satisfaction ◽  
Anaesthesia Care ◽  
Group D

BACKGROUND Middle ear surgeries done under local anaesthesia require adequate patient sedation and analgesia to prevent patient anxiety and movement during surgical procedures. This study was undertaken to compare dexmedetomidine and propofol for their sedative and analgesic properties, safety profile, adverse events and recovery profile in patients undergoing middle ear surgery under monitored anaesthesia care. METHODS This is a prospective observational study. 96 patients of both sexes, of American society of anaesthesiologist (ASA) grade I or II, between 18 - 60 years of age were randomly divided into two groups; group D and group P consisting of 48 patients each. Patients in group D received a loading dose of injection dexmedetomidine 1 µg / kg I.V. over 10 minutes followed by an infusion at a rate of 0.5 µg / kg / hr. Patients in group P received a loading dose of injection propofol 75 µg / kg / min. I.V. over 10 min followed by an infusion at a rate of 50 µg / kg / min. Time taken to achieve the modified Aldrete score of 10 was compared between both the groups. Before discharge from post anaesthesia care unit (PACU), patient’s satisfaction with sedation & surgeon satisfaction was recorded on Likert scale. Time to rescue analgesia was compared. RESULTS The Bi-Spectral Index values in intra-operative period were on the lower side in the group D as compared to the corresponding values in the group P, but P values were statistically insignificant suggesting that both dexmedetomidine and propofol produced similar sedation. Time to rescue analgesia was greater for group D. CONCLUSIONS Having similar sedation effect, dexmedetomidine was better than propofol for sedation in patients undergoing middle ear surgery under monitored anaesthesia care. KEYWORDS Dexmedetomidine, Propofol, Monitored Anaesthesia Care, Bi-spectral Index

scholarly journals A comparative study between magnesium sulphate and dexmedetomidine for deliberate hypotension during middle ear surgery

2011 ◽  
Vol 27 (4) ◽  
pp. 227-232 ◽  
Author(s):  
Ossama H. Aboushanab ◽  
Ahmed M. El-Shaarawy ◽  
Ahmed M. Omar ◽  
Hisham H. Abdelwahab
Keyword(s):  
Comparative Study ◽  
Middle Ear ◽  
Magnesium Sulphate ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Deliberate Hypotension

scholarly journals A comparative study of endoscopic assisted versus conventional middle ear and mastoid surgery at a tertiary care teaching hospital

2021 ◽  
Author(s):  
Jitendra Kumar Sharma ◽  
Sushma Mahich ◽  
Navneet Mathur
Keyword(s):  
Comparative Study ◽  
Middle Ear ◽  
Operative Time ◽  
Middle Ear Surgery ◽  
Wide Field ◽  
Time Duration ◽  
Ear Surgery ◽  
Significant Difference ◽  
Duration Of Surgery ◽  
Mastoid Surgery

<p><strong>Background:</strong> Objectives were to compare outcomes, intra operative visualization and operative time duration in endoscopic assisted vs conventional middle ear and mastoid surgery.</p><p><strong>Methods: </strong>This prospective comparative study was conducted in 50 patients; among them 25 cases were of endoscope assisted middle ear surgery and 25 cases with conventional microscopic middle ear surgery. A 4 mm diameter, 18 cm long rigid, zero-degree endoscope and operating microscope was used. Primary outcomes include mean average pre and post operative air-bone (A-B) gap, hearing thresholds, intra operative visualization and duration of surgery.<strong></strong></p><p><strong>Results: </strong>Mean A-B gap closure for endoscopic assisted tympanoplasty was 12.76±6.00 dB, while it was 8.38±5.78 dB for non-endoscopic assisted tympanoplasty. The results were comparative. Mean intra-operative time duration for endoscopic assisted tympanoplasty was 70.23±4.17 min, while it was 77±9.80 min for non-endoscopic assisted tympanoplasty with statically significant difference between both groups (p=0.03). Graft uptake rate for endoscopic assisted tympanoplasty was 92.31% while it was 84.62% for non-endoscopic assisted tympanoplasty. Residual cholesteatoma remnant on endoscopy was found in 43.66% cases out of 12 mastoidectomy cases performed via endoscopic assistance.<strong></strong></p><p><strong>Conclusions: </strong>The endoscope can be successfully applied to ear surgery for most of the ear procedures with a reasonable success rate both in terms of perforation closure and hearing improvement and with minimal exposure. Wide-field zero, 30 or 70° endoscope sallow visualization of hidden anatomic spaces and working around corners i.e., epitympanum, hypotympanum and retro tympanum for safe removal of cholesteatoma.</p>

scholarly journals Patient satisfaction in middle ear surgery under monitored anaesthesia care

2019 ◽  
Vol 1 (2) ◽  
pp. 61-65
Author(s):  
Maya Lama ◽  
Rohini Sigdel ◽  
Sanish Gurung ◽  
Krishna Bogati ◽  
Bibek Ranjit
Keyword(s):  
Patient Satisfaction ◽  
Middle Ear ◽  
Middle Ear Surgery ◽  
Ear Surgery ◽  
Patient’S Satisfaction ◽  
Number Of Patients ◽  
Therapeutic Procedures ◽  
Anaesthesia Service ◽  
One Year ◽  
Anaesthesia Care

Background: Monitored anaesthesia care is a specific anaesthesia service for diagnostic or therapeutic procedures performed under local anaesthesia along with sedation and analgesia titrated to a level with the provision to convert into general anaesthesia when required. We conducted a retrospective study to determine patient satisfaction in middle ear surgery under monitored anaesthesia care. Materials and Methods: The number of patients undergoing middle ear surgery under monitored anaesthesia care, over a period of one year were included. They received sedation with midazolam 0.02 mg/kg and fentanyl 1 mcg/kg along with local anaesthetic infiltration. Patient’s satisfaction was measured using a five point Likert scale. Intraoperative pain, nausea, vomiting and other discomforts were inquired. Results: The total number of patients was 64. Fifty-one patients (79.7%) were satisfied, 10 were neutral (15.6%) and 3 patients (4.7%) were dissatisfied with the technique. Earache (4.7%), followed by dizziness (3.1%) and bodyache (3.1%) were the most common cause of discomfort. Nausea occurred in 6 patients (9.4%) and vomiting in 5 patients (7.8%). Conclusion: Middle ear surgeries can be performed under monitored anaesthesia care with good patient satisfaction.

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