Addition of Dexmedetomidine to Propofol Anesthesia for Middle-Ear Surgeries: A Prospective Randomized Double-Blind Study.

Autor: Kumari K S; Anaesthesiology, Yenepoya Medical College and Hospital, Mangalore, IND., Thippeswamy HG; Anaesthesiology, Yenepoya Medical College and Hospital, Mangalore, IND., Nayak SR; Anaesthesiology, Yenepoya Medical College and Hospital, Mangalore, IND., Torgal SV; Anaesthesiology, SDM College of Medical Sciences and Hospital, Dharwad, IND.
Jazyk: angličtina
Zdroj: Cureus [Cureus] 2024 Aug 28; Vol. 16 (8), pp. e68025. Date of Electronic Publication: 2024 Aug 28 (Print Publication: 2024).
DOI: 10.7759/cureus.68025
Abstrakt: Background Middle-ear surgery commonly performed under a microscope requires a bloodless field provided by hypotensive anesthesia. Our objective was to study the effects of dexmedetomidine on propofol consumption and intraoperative hemodynamic stability. Methods One hundred adults undergoing elective middle-ear surgery were randomized into two groups. The propofol+dexmedetomidine group (Group PD) received a loading dose of dexmedetomidine 1μg/kg in 10ml normal saline over 10min followed by infusion of the same at 0.5μg/kg/h. Propofol-only group (Group P) received 10ml normal saline over 10min followed by an infusion of the same. General anesthesia was induced with intravenous morphine, propofol, and vecuronium, and maintained with propofol, oxygen, and N 2 O. During microscope use, we aimed to maintain mean arterial pressure (MAP) within 60-69mmHg. Results There was no significant difference in the mean (SD) consumption of propofol [Group P 8.6 (2.1)mg/kg/h vs Group PD 8.1 (1.5)mg/kg/h, P =0.172]. The induction dose of propofol was significantly less in Group PD [1.8 (0.3) vs 2 (0.4)mg/kg, P <0.001]. Except for the baseline value, the heart rate was significantly lower in Group PD, P <0.001. The time duration during which MAP was within 60-69mmHg was higher in Group P [37.5 (36.8) vs 30.9 (38.3)min] though the difference was not statistically significant. The recovery was delayed in Group PD [25.4 (8.6) vs 17.6 (4.9)min, P <0.001]. Group PD had a significantly better operative field, P =0.0003. Conclusion The addition of dexmedetomidine did not reduce propofol consumption but reduced the induction dose of propofol. Propofol and dexmedetomidine combination provided comparable mean arterial pressure and better operative field but caused delayed recovery.
Competing Interests: Human subjects: Consent was obtained or waived by all participants in this study. Institution Ethics Committee of SDM College of Medical Sciences and Hospital issued approval SDMIEC:395:2012. Ref id: SDMIEC:395:2012 Am happy to inform you that permission is granted to you to carry out your study titled "Evaluation of Addition of Dexmedetomidine to Propofol Anaesthesia for Middle Ear Surgeries: Prospective Randomized Double-Blind Study". Thanking you, Member Secretary. Animal subjects: All authors have confirmed that this study did not involve animal subjects or tissue. Conflicts of interest: In compliance with the ICMJE uniform disclosure form, all authors declare the following: Payment/services info: All authors have declared that no financial support was received from any organization for the submitted work. Financial relationships: All authors have declared that they have no financial relationships at present or within the previous three years with any organizations that might have an interest in the submitted work. Other relationships: All authors have declared that there are no other relationships or activities that could appear to have influenced the submitted work.
(Copyright © 2024, Kumari K. et al.)
Databáze: MEDLINE
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