Comparative Evaluation Of Dexmedetomidine Research Articles

Comparative Evaluation of Dexmedetomidine and Clonidine on Propofol Consumption, Haemodynamics and Postoperative Recovery in Laparoscopic Surgeries: A Prospective, Double-Blind, Placebo-Controlled, Randomised Study

Background and Aims: Laparoscopic surgery is associated with significant haemodynamic changes due to pneumoperitoneum formation. Various studies have demonstrated that α2 adrenergic agonists, such as clonidine and dexmedetomidine, prevent the haemodynamic response due to pneumoperitoneum during laparoscopic surgery. Methods: A total of 104 female patients undergoing laparoscopic hysterectomies were divided into three groups at random. Group D patients were administered a loading dose of 1 μg/kg of dexmedetomidine prior to induction over a period of 15 minutes and a maintenance dose of 0.5 μg/kg/h during the surgical procedure. Group CL patients were given a loading dose of 2 μg/kg of clonidine before induction over a period of 15 minutes and a maintenance dose of 1 μg/kg/h during the surgery. Group C received same volume of normal saline over same duration and maintenance infusion throughout the surgery. The primary outcome was the haemodynamic changes at different time interval. The secondary outcome was the response to verbal commands, extubation time and orientation time. Results: There was no significant difference in heart rate and blood pressure values between group D and group CL during whole study period. Whereas in group C, there was a statistically significant increase in heart rate and blood pressure after intubation and during pneumoperitoneum period ( P < 0.05). Extubation time and orientation time were significantly delayed in group D and group CL when compared with group C and D ( P < 0.05). Conclusion: Clonidine or dexmedetomidine effectively attenuates the haemodynamic changes in patients undergoing laparoscopic hysterectomies compared to the control group.

Comparative Evaluation of Dexmedetomidine and Magnesium Sulfate for Prevention of Postoperative Atrial Fibrillation in Patients of Coronary Artery Bypass Surgeries.

Introduction The main goal of this study is to compare the effects of dexmedetomidine and magnesium sulfate on preventing atrial fibrillation (AF) after off-pump coronary artery bypass graft (CABG) surgeries. AF is a type of irregular heartbeat that often occurs after heart surgery and can cause serious complications. We want to see which drug is more effective in reducing the risk of AF in patients who have had CABG surgeries without using a heart-lung machine. Materials and methods This was a randomized clinical study, conducted on patients of ASA classes III and IV who were the candidates for off-pump coronary artery bypass graft surgeries, which were conducted in the cardiac operating room from the periodOctober 2020 to April 2021, at the Department of Anaesthesia, Jawaharlal Nehru Medical College, Sawangi, Meghe. All patients were aged between 30 and 85 years and with a left ventricular ejection fraction of above 40%. Results When the two groups were compared, the incidence of arrhythmias was more in group D (a group that received injection dexmedetomidine infusion), predominantly AF with an incidence of 50% more as compared to group M (a group that received injection magnesium sulfate infusion). When hemodynamic parameters were compared, events of bradycardiaand hypotension were significantly higher in group Das compared to group M. The heart rate (HR), when compared between the two groups intraoperatively from the duration before induction of anesthesia till during sternum closure, has a significant p-value (0.0001). Similarly, when the mean arterial pressure (MAP) was compared between the two groups intraoperatively, significant hypotension was noted in group D (p-value = 0.0001). Postoperatively, in the intensive care unit when the HR and MAP were compared for 48 hours, bradycardia and hypotension were noted, but drastic changes in the mean values of the HR and MAP were not seen in both groups D and M. Conclusion When comparing the antiarrhythmic properties of the study drugs, it was observed that intraoperative and postoperative arrhythmias were less with magnesium sulfate as compared with dexmedetomidine. It was also found that there were higher events of hypotension and bradycardia in the dexmedetomidine group as compared to the magnesium sulfate group.

Comparative Evaluation of Dexmedetomidine and Dexamethasone as Adjuvants in Supraclavicular Brachial Plexus Block.

Introduction Currently, peripheral nerve block has shown immense potential with effective patient satisfaction. In the event of upper limb surgeries, the supraclavicular brachial plexus approach under ultrasound guidance renders quick and dense anesthesia. In addition, the clinical utility of adjuvants with local anesthetics elicits a good quality of nerve block with improved duration and inset. So the aim of the present study was tocompare the block characteristics of dexmedetomidine and dexamethasone during supraclavicular brachial plexus block in patients undergoing upper limb surgeries. Materials and methods The present study was conducted on 100 patients aged 20-60 years with the American Society of Anesthesiologists (ASA)-I and ASA-II classification who were scheduled for upper limb surgeries. These patients were divided equally into two groups, namely group D (who received 20mL of 0.5% bupivacaine + 50 mcg (0.5mL) of dexmedetomidine +1.5mL normal saline) and group X (who received 20mL of 0.5% bupivacaine +8mg of dexamethasone), ensuring a total volume of 22mL administered to both groups. The time of onset and duration of the sensory and motor blocks, as well as the quality of intraoperative analgesia, were assessed. Results The addition of dexmedetomidine (50mcg) and dexamethasone (8mg) to 0.5% bupivacaine ensured a faster onset and prolonged duration of the sensory and motor blocks. Additionally, dexmedetomidine resulted in more prolonged postoperative analgesia, a lower mean visual analogscale score in the first 24 hours, and lesser opioid consumption in 24 hours than dexamethasone. Conclusion Dexmedetomidine is superior to dexamethasone as an adjuvant to bupivacaine during supraclavicular brachial plexus block in patients undergoing upper limb surgeries.

A comparative evaluation of dexmedetomidine and magnesium sulfate during awake fiber optic orotracheal intubation in patients scheduled for cervical spine surgeries: A prospective study

Background: Fiber optic intubation has become an integral part in management of anticipated difficult airways. Various anesthetic drugs have been used to assist awake fiber optic intubation (AFOI) for producing conscious sedation to provide a calm, cooperative, and responsive patient without respiratory depression for successful awake fibre optic intubation. Aims and Objectives: The aim of the present study was to compare the efficacy of dexmedetomidine and magnesium sulfate during awake fiber optic orotracheal intubation in patients scheduled for cervical spine surgeries. Materials and Methods: A randomized, prospective, and comparative study design was conducted in 60 patients in JAH group of hospitals. All patients were randomly divided into two groups: Group A (n=30) patients received dexmedetomidine (1 μg/kg) and Group B (n=30) patients received magnesium sulfate (40 mg/kg) in 100 ml normal saline over 10 min. The fiber optic orotracheal intubation was performed and primary outcome was level of sedation assessed using Ramsay sedation score. Other parameters of study included cough score and intubation score to compare intubating conditions. The secondary outcomes of study included variations in hemodynamic parameters heart rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure, and SPO2 during drug infusion at 2-min interval, immediately after intubation and every 10 min after intubation till 30 min. Results: Group A (Dexmedetomidine) had better sedation score, cough score, and intubation score with stable hemodynamic variables than Group B (Magnesium Sulphate) with statistically significant results. Conclusion: Patients receiving dexmedetomidine had better sedation providing more optimum conditions for AFOI with stable hemodynamic parameters and lesser adverse effects during the procedure than magnesium sulfate.

Comparative Evaluation of Dexmedetomidine, Ketamine & their Combination for Epidural Analgesia in Orthopedic Surgeries of the lower Limb

Background: Epidural anesthesia is a perioperative pain control treatment that has a variety of applications in anaesthesiology. It could be used as as a primary anaesthetic, although it's most usually utilised as an adjuvant for management of pain. It could be a one-time shot or a continuous infusion for a long-drawn therapeutic intervention. Apart from the potential for significant analgesia, its use minimises the need for other anaesthetics and analgesics, lowering the risk of adverse effects. It has also been proven to lower the level of cortisol, to facilitate the resumption of bowel function, reduce the risk of Pulmonary embolism and deep vein thrombosis in the post-operative phase, while minimizing the duration of institutional stays.
 Aim: Comparison and Evaluation of the effect of the drugs dexmedetomidine , ketamine & them together as a combination in addition to bupivacaine, as an adjuvant for intermittent epidural top ups for lower limb orthopaedic surgeries .
 Study Design: Prospective observational study.
 Place and duration of Study: The study will be conducted over a period of 2 years and 6 months in the department of anaesthesiology, Jawaharlal Nehru medical college and Acharya vinoba bhave rural hospital, wardha.
 Methodology: Our prospective, comparitive observational study included 90 patients randomly assigned into 3 sets of 30 each, one was administered dexmedetomidine epidurally, one was given ketamine and one was given their combination epidurally [1]. The quality and duration of analgesia provided by all 3 groups were then compared to find out which of them provides better and prolonged pain relief. Along with analgesia, the other parameters assessed were hemodynamic response, sedation and any other side effects.
 Expected Results: We're attempting to establish the hypothesis that the combination of both the drugs is better than dexmedetomidine or ketamine administered individually. It has been proved in various researches that epidural ketamine prolonged the duration of analgesia, [2] but it was less than epidural dexmedetomidine. We expect that the combination would decrease the postoperative rescue analgesics requirements and less hemodynamic alterations hence providing greater patient satisfaction as compared to the two drugs separately.

A Comparative Evaluation of Dexmedetomidine vs Clonidine used as Adjuvants with Hyperbaric Bupivacaine in Patients with Preeclampsia Undergoing LSCS

Relief of operative as well as post operative pain should be the prime responsibility of an anesthesiologists. The most common treatment for post operative pain remains conventional intramuscular injection of narcoticswhich are associated with several side effects like nausea, vomiting, itching, hypotension, bradycardia,urinary retention, dysphoria,respiratory depression, early and later. Pregnancy induced hypertension is a major cause of morbidity and mortality in obstetrics, complicating 3-8% of pregnancies. Severe preeclampsia poses a dilemma for anesthesiologists, and there is some controversy about the best anaesthetic technique for caesarean delivery in such cases. Though spinal anasthesia reduces the risk of airway instrumentation in high risk patients of preeclampsia, there are still limitations about its limited duration of analgesia. In present study we intend to compare dexmedetomidine and clonidine used with hyperbaric bupivacaine for spinal anaersthesiain patients with preeclampsia undergoing LSCS. Primary Objective: To compare the clinical efficacy of intra the caldexmedetomidine vs Clonidine on: (a) Onset and duration of sensory block (b) Onset and duration of motor block (c) Duration of analgesia (d) Side effects if any. Secondary Objective: to compare the haemodynamic profile among patients of the two group. Methodology: All eligible patients were randomly assigned into two groups of 50 each by chit and envelope method: Group A: SAB was given with 2ml, 0.5 % Bupivacaine(H) + 45 µg Clonidine. Group B: SAB to be given with 2ml, 0.5% Bupivacaine (H) + 5µg dexmedetomidine. Results: Regression of sensory block was prolonged in group B as compared to group A.(p value <0.0001). There was regression of motor block in group B as compared to group A. p value<0.0001Heart rate remained stable and comparable at different time points in 2 groups. Except three patients in group A and one patient in group B, no other patient in either group developed bradycardia. Three patients in group A and in group B developed hypotension which responded to intravenous fluid therapy. Sedation score decreased to 0 within 5 hours. At no time, sedation score exceeded 2 and no patient developed signs of respiratory depression. Conclusion: Dexmedetomidine in the dose of 5µg added to 10 mg 0.5% Hyperbaric Bupivacaine in SAB for LSCS surgery in parturients with preeclampsia provides comparable onset for sensory and motor blockade but significantly prolonged duration as compared to 45µg of clonidine. Longer duration of postoperative analgesia with 5µg Dexmedetomidine makes it superior to clonidine in respect to postoperative analgesia. Both the drugs produce desirable level of intraoperative and postoperative sedation, stable hemodynamics and minimal side effects.

Comparative Evaluation of Dexmedetomidine and Magnesium Sulphate in Mitigating Pressor Response while Extubation in Patients undergoing Mastoidectomies

Background: Ear surgeries performed under general anaesthesia mandate smooth emergence after surgery to facilitate a good surgical outcome. We conducted this study with primary objective of comparing dexmedetomidine and magnesium sulfate (MgSO4) in attenuating extubation response after mastoid surgeries. The secondary outcome was to study the adverse effects if any.
 Methods: Sixty patients of ASA grade I and II, aged 18 -50 yrs were randomized into 2 groups of 30 each receiving either dexmedetomidine 0.5μg/kg or MgSO4 30 mg/kg respectively 10 minutes prior to completion of surgery. Efficacy of both drugs in attenuating cough reflex, PONV, shivering and fluctuations in haemodynamic response were recorded. Postoperative sedation was noted. Any laryngospasm, bronchospasm, hypotension, bradycardia, desaturation was also noted.
 Statistical analysis: The observations were recorded and analysed using statistics calculator SPSS 19.00 version. Student’s t test and χ2 (chi square) test were used to analyze quantitative and qualitative data respectively. P-value<0.05 was considered statistically significant.
 Results: The variations in systolic, diastolic blood pressure and heart rate were significantly less with dexmedetomidine as compared to MgSO4 (p<0.01). Incidence of coughing (p=0.002), PONV(p=0.002), was less with dexmedetomidine while shivering control was similar in both groups, the sedation was more with dexmedetomidine (p=0.004). Patients with dexmedetomidine infusion were more satisfied in terms of reduced nausea sensation, drowsiness.
 Conclusion: Dexmedetomidine provides a smoother recovery profile as compared to MgSO4 when administered prior to extubation improving the surgical outcome and patient satisfaction in patients undergoing mastoidectomies.

Comparative evaluation of dexmedetomidine and fentanyl in total intravenous anesthesia for laparoscopic cholecystectomy: A randomised controlled study.

Background and Aims:Laparoscopic cholecystectomy is one of the commonly performed ambulatory surgeries. The selection of anesthetic agents for ambulatory surgeries should be done bearing in mind the need for early discharge. Opioids form an integral component of total intravenous anesthesia (TIVA) but their associated side effects may result in an increased hospital stay. Hence, we planned a study to compare the opioid (fentanyl) and non-opioid (dexmedetomidine) based technique of TIVA for laparoscopic surgery.Material and Methods:Ninety ASA I and II patients between 18-60 years of either sex posted for laparoscopic cholecystectomy were randomly allocated into two groups namely group D (Dexmedetomidine) and group F (Fentanyl). Patients received propofol infusion along with group specific drug infusion, after which an appropriate size proseal laryngeal mask airway was placed. The patients were assessed for discharge time from post-anesthesia care unit (PACU), on table recovery time, time to first rescue analgesia, hemodynamic parameters, incidence of postoperative nausea and vomiting (PONV) and any other complication.Results:Demographic profile of both the groups was comparable. Group D had longer on table recovery time (13.00 ± 2.34 min vs 6.29 ± 2.46 min; P < 0.001) and time to discharge from PACU (6.80 ± 3.96 min vs 2.36 ± 1.67 min; P < 0.001) compared to group F. Group F had better hemodynamic stability compared to group D. In group D, 77% patients required rescue analgesia in first one hour post surgery, unlike 22% in group F. No patient in group D had PONV.Conclusion:Opioid based technique (Fentanyl) of TIVA is superior over non-opioid based (dexmedetomidine) technique with faster recovery, early discharge, decreased postoperative pain scores and better hemodynamic stability. PONV is observed with opioids which can be treated successfully with antiemetics.

Comparative Evaluation of Dexmedetomidine and Fentanyl Infusion on Haemodynamic Response in Patients Undergoing Elective Surgery Under General Anaesthesia

Context: The procedures like laryngoscopy and intubation evoke stress response in patients undergoing elective surgeries under general anaesthesia Aims: To compare and evaluate dexmedetomidine and fentanyl on hemodynamic response like Heart Rate (HR), Systolic Blood Pressure (SBP), Diastolic Blood Pressure (DBP), Mean Arterial Pressure (MAP) in patients during intubation and extubation. Settingsand Design: Doubleblinded Randomised Control prospective Study Materials and Methods: AAfterobtainingethical clearance, 90 patients belonging to American Society of Anaesthesiologists class I/II, Scheduled for surgeries with duration of approx. 90mins were randomly divided into two groups. Group A received dexmedetomidine 1µg/ kg as loading dose over 10mns prior to induction followed by infusion at 0.5µg/kg/hr until 10mins prior to extubation. Group B received IV Fentanyl 1µg/kg as loading dose over 10mins prior to induction followed by infusion at 0.5 µg/kg/hr until 10mins prior to extubation. Exclusion criteria included cardiovascular disease, Obesity &gt;30kg/m2, patients with anticipated difficult airway, on sedatives, hypnotics and who have allergy to the study drug. Statistical analysis used: Data analyzed- SPSS22.0 software. Test of significance: Chi-squaretest. Continuousdata: Mean standard deviation. Testof significance:Independentttest p value: &lt;0.05- statistically significant.&gt; Results: With respect to hemodynamic response during intubation and extubation, Group A has shown significantly lower HR, SBP, DBP and MAP in comparison to Group B. Postoperative Visual Analogue Score for first 24hrs was significantly less in Group A compared to Group B. Conclusion: Dexmedetomidine is better and safe alternative to fentanyl in attenuating hemodynamic response during both intubation and extubation.

Comparative Evaluation of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine for Epidural Anesthesia in Lower Limb Orthopaedic Surgeries

Comparative Evaluation of Dexmedetomidine and Fentanyl as Adjuvants to Ropivacaine for Epidural Anesthesia in Lower Limb Orthopaedic Surgeries

Comparative evaluation of dexmedetomidine and labetalol for attenuating hemodynamic stress responses during laparoscopic cholecystectomy in borderline hypertensive patients

Abstract Objective Various pharmacological agents have been tried to attenuate the pressor response in laparoscopic cholecystectomy patients. We have compared single pre-induction intravenous injection of dexmedetomidine with labetalol for attenuation of hemodynamic stress response. Methods A total of 160 patients were considered for this prospective, randomised, double blind clinical study done in a single tertiary care institution. Patients were either included in group D, to receive 1.0 μg kg−1 i.v. dexmedetomidine or group L, to receive 0.3 mg kg−1 i.v. labetalol in 100 ml of normal saline before induction of anaesthesia. Patient's hemodynamic parameters were noted pre-operatively before starting infusion and at fixed intervals afterwards till extrubation. Results After intubation, mean systolic blood pressure (SBP) was higher in patients of group L (128.0 ± 13.866) as compared to group D (123.2 ± 10.672). Afterwards the SBP was comparable until extrubation. Similarly, after intubation patients in group D tended to have lower diastolic pressure (73.1 ± 9.683 vs. 79.2 ± 14.153, p value 0.0017) compared to patients in group L. Also, the relative incidence of bradycardia and hypotension was higher in patients who had received inj. labetalol. Conclusion In patients predisposed to significant fluctuations in blood pressure or heart rate dexmedetomidine may be more suitable than labetalol due to better preservation of normal hemodynamics especially during periods of stress showing a relatively lower incidence of side effects.

Dexmedetomidine and fentanyl for epidural analgesia in lower limb orthopedic surgeries: a comparative evaluation

Background: Epidural anesthesia is the most frequently used technique for providing operative analgesia in lower abdominal and limb surgeries. This study aimed at comparative evaluation of dexmedetomidine and fentanyl for epidural anaesthesia in lower limb orthopedic surgeries.Methods: This study was conducted in the department of Anesthesiology and critical care Medicine, MLB Medical College Jhansi. Patients undergoing lower limb orthopaedic surgery aged between 21 to 50 years and belonging to American Society of Anaesthesiologist (ASA) grade 1or 2 were included. Informed and written consent was obtained. Subjects were divided into two groups. Statistical analysis was done using SPSS version 16.0 software. t-test, Chi-square test, and Mann-Whitney tests were applied.Results: Age wise distribution, body weight and mean duration of surgical time was comparable in both groups and found statistically insignificant. Time to achieve sensory level at T10 was found to be significantly less in Group RD as compared to Group RF. Early onset of motor block in Group RD was seen (10.12min) as compared to fentanyl (13.36min). Complete motor block was achieved in significantly lower time by Group RD as compared to Group RF. Duration of motor block was significantly higher in Group RD as compared to Group RF subjects. Better sedation score was found in Group RD.Conclusions: Dexmedetomidine is better as an adjuvant to ropivacaine than fentanyl for epidural anaesthesia because of intense analgesia, better quality of motor block and prolong post-operative analgesia, along with higher sedation scores.

Comparative Evaluation of Dexmedetomidine and Esmolol for Attenuation of Intubation Stress Response in well Controlled Hypertensive Patients – A Double-Blind Randomized Control Study

Comparative Evaluation of Dexmedetomidine and Esmolol for Attenuation of Intubation Stress Response in well Controlled Hypertensive Patients – A Double-Blind Randomized Control Study

A Comparative Evaluation of Dexmedetomidine and Tramadol for Control of Post-spinal Anesthesia Shivering

A Comparative Evaluation of Dexmedetomidine and Tramadol for Control of Post-spinal Anesthesia Shivering

Comparative Evaluation of Dexmedetomidine and Pregabalin as Premedication Agent to Attenuate Adverse Hemodynamic and Stress Response in Patients Undergoing Laparoscopic Cholecystectomy.

Background:Laparoscopic cholecystectomy is the most commonly performed laparoscopic procedure. The goal of anesthetic management is to minimize stress response and early discharge. Dexmedetomidine, and pregabalin have been used successfully to attenuate laryngoscopy and intubation response in various surgical procedures.Aim:To compare efficacy of pregablin and dexmedetomidine in attenuating hemodynamic and stress response.Setting and Design:A prospective, double blind randomized trial comprising 130 ASA physical status class I and II patients posted for laparsoscopic cholecystectomy.Materials and Methods:Patients were randomized in to Group A and Group B. Group A received intravenous dexmedetomidine in a dose of 1 ug.kg-1, through an infusion pump 20 min prior to induction of anaesthesia. Group B subjects received oral pregabalin 150 mg. Parameters observed were vitals, discharge time, cortisol level, side effects if any.Results:Post intervention heart rate got reduced significantly in Group A and it remained low in comparison to baseline during whole peri-operative period. In Group B, immediate post-pneumoperitoneum heart rate, and post exubation heart rate was higher than baseline. Blood pressure (BP) decreased significantly post intervention in Group A which persisted till pneumoperitoneum. In Group B there was statistically significant rise in systolic, diastolic and mean blood pressure postpneumoperitoneum as compared to baseline blood pressure. Post-operative cortisol level was significantly higher than baseline values and the level is more in Group B.Conclusion:Intravenous dexmedetomidine is more effective than oral pregabalin in attenuating perioperative stress response.

Treatment of delirium in early postoperative cardiosurgical patients. Article

Background. Postoperative delirium is highly relevant in elderly patients who undergo cardiosurgical interventions with cardiopulmonary bypass (CPB), long stay in intensive care unit (ICU), suffering from widespread atherosclerosis and having a wide range of comorbidities. In the world literature there is a lot of data on the successful use of dexmedetomidine for sedation, prevention and relief of delirium, including patients after open-heart interventions. Comparative evaluation of dexmedetomidine and neuroleptic sedation with “traditional” for Russian Federation management of cardiosurgical patients suffering from postoperative delirium seems to be a relevant clinical and research task. Objectives. Comparative evaluation of the effectiveness of drug sedation with dexmedetomidine and propofol in cardiosurgical patients with postoperative delirium. Material and Methods. An open prospective cohort study took place in 2017–2019 and included 42 patients who underwent open-heart intervention with CPB and had delirium in the postoperative period. Exclusion criteria: severe brachiocephal artery atherosclerosis, acute period or consequences of stroke, signs of acute respiratory failure associated with the pathology of the respiratory system, severe cardiovascular failure, age over 80 years. Detection and treatment of delirium were performed by an intensivist together with a psychiatrist. Haloperidol was used as the main antipsychotic. Depending on the drug used for medical sedation, the patients were divided into 2 groups: 22 patients underwent medical sedation with propofol, 20 with dexmedetomidine in the form of an extended infusion. According to the results of the study, the length of patients’ stay in the ICU and hospital, the need for vasopressor therapy, mechnical ventilation (MV), and the duration of delirium were analyzed. Results. In patients of the dexmedetomidine group, compared with the propofol group, the following was observed: less need for vasopressors and the duration of their use, less frequent use of MV (27.2 % versus 10.0 % of cases, p &lt; 0.05), shorter stay in ICU (4.4 ± 1.8 vs 7.2 ± 2.3 days, p &lt; 0.05), and finally, more rapid relief of the delirium itself (34.7 ± 6.8 vs 52.6 ± 8.9 hours, p &lt; 0.05). There was no statistically significant difference between the groups for the length of hospital stay. Conclusions. In the early postoperative period of open-heart interventions, medical sedation using dexmedetomidine as a component of the delirium therapy seems to be preferable to propofol sedation. Using of dexmedetomidine during study was associated with more rapid relief of the delirium, more favorable hemodynamic profile, less need for MV and duration of MV, as well as shorter duration of stay in the ICU, compared with the use of propofol sedation, which allows us to recommend routine use of dexmedetomidine in the cardiosurgical ICU.

Comparative Evaluation of Dexmedetomidine and Propofol Along With Scalp Block on Haemodynamic and Postoperative Recovery for Chronic Subdural Haematoma Evacuation Under Monitored Anaesthesia Care.

Chronic subdural haematoma (CSDH) is a common neurosurgical problem, and treatment includes evacuation of the haematoma by burr hole drainage. Commonly, these procedures are performed under local anaesthesia, general anaesthesia or, recently, with monitored anaesthesia care (MAC). We compared dexmedetomidine- and propofol-based sedation along with scalp nerve block for burr hole evacuation of CSDH. In this prospective randomised study, 62 patients were divided into the following two groups of 31 patients each: Group D and Group P. Group D received dexmedetomidine 1 μg kg-1 over 10 minutes as a loading dose, followed by 0.2-0.7 μg kg-1 hr-1. Group P received propofol 1 mg kg-1 over 10 minutes as a loading dose, followed by 1-3 mg kg-1 hr-1. The heart rate (HR) and blood pressure were measured at different intervals. The recovery parameter and satisfaction score were also recorded. There were no significant differences noted in the demographic profile. A significant decrease in HR compared to preoperative value was seen in Group D compared to Group P. Blood pressure values were statistically significantly lower in both study groups, compared to preoperative values during the whole procedure and after surgery (p<0.05). Time to achieve modified Aldrete score of 9-10 was not significantly different between the groups (p=0.354). Surgeon satisfaction was significantly better in Group D compared to Group P (p<0.05), but patient satisfaction was similar between the groups (p=0.364). Dexmedetomidine-based sedation compared to propofol, along with scalp block for MAC in patients undergoing burr hole evacuation of CSDH is associated with haemodynamic stability and greater surgeon satisfaction.

Comparative Evaluation of Dexmedetomidine and Tramadol for Attenuation of Post-Spinal Anaesthesia Shivering

Comparative Evaluation of Dexmedetomidine and Tramadol for Attenuation of Post-Spinal Anaesthesia Shivering

A Comparative Evaluation of Dexmedetomidine and Midazolam in Monitored Anaesthesia Care for Tympanoplasty

A Comparative Evaluation of Dexmedetomidine and Midazolam in Monitored Anaesthesia Care for Tympanoplasty

A comparative evaluation of dexmedetomidine and fentanyl to attenuate hemodynamic response to laryngoscopy and intubation

Background: Laryngoscopy and intubation are associated with a sympathetically mediated circulatory response due to irritation of respiratory tract which is associated with increase in pulse rate and blood pressure that may be dangerous.Aims and Objectives: The aim of the present study was to determine and compare the efficacy of dexmedetomidine and fentanyl in attenuating the hemodynamic response to laryngoscopy and intubation and to detect any complication or side effect as a result of these drugs.Materials and Methods: Following approval by ethical committee, 60 ASA grade I and II patients of either sex undergoing general anaesthesia for elective surgery were included in this study. Patients were randomly divided into two groups of 30 patients each. Dexmedetomidine in a dose of 1μg/kg was given to Group A patients and Fentanyl 2 μg/kg was given to Group B patients. Both the drugs were diluted with normal saline solution to make 10ml and were administered slow intravenous 10 min before induction.The hemodynamic parameters were recorded, demographic data was analyzed using unpaired t-test and hemodynamic variables were analyzed by using unpaired and paired t-test. Side effects were analyzed using chi square test.Result: The two groups were comparable in their demographic profiles. Dexmedetomidine proved itself to be an excellent drug when given intravenously as a premedicant in dose of 1μg/kg to attenuate hemodynamic response to laryngoscopy and intubation. It blunted the hemodynamic response to laryngoscopy and intubation to a greater magnitude than fentanylin a dose of 2μg/kg intravenously as a premedicant.Conclusion: We conclude that fentanyl 2μg/kg i.v. given ten minutes prior to airway instrumentation shows an inconsistent response to laryngoscopy and intubation. Between the two drugs under study, the use of dexmedetomidine 1μg/kg i.v. is satisfactory and produces a more favorable hemodynamic profile while fentanyl 2μg/kg is found to be non- dependable and less effective for the attenuation of the pressor response to laryngoscopy and endotracheal intubation. However, further larger studies are required to strengthen these conclusions.Asian Journal of Medical Sciences Vol.9(1) 2018 65-72