Background and Aims: It is a common practice to perform procedures like Tympanoplasty and Myringoplasty under Monitored Anaesthesia care (MAC). The recently introduced selective ?2 agonist dexmedetomidine, known for its opioid sparing effect along with sedative, analgesic hypotensive and anaesthetic properties with minimal respiratory depression has been used as a sole agent to provide MAC in various surgical interventions. The present study is aimed to evaluate the role of Dexmedetomidine as a sole sedoanalgesic agent and compare the efficacy of adding an adjuvant like Butorphanol to Dexmedetomidine. Material & Methods: 60 patients of either sex, aged 18-20 years, ASA grade I&II were randomized into two groups(D and BD) of 30 patients each for microscopic ear surgery under Local Anaesthesia(LA) with MAC. Group D received inj. Dexmedetomidine 1 mcg/kg iv loading dose while Group BD received inj. Dexmedetomidine 1 mcg/kg iv loading dose along with inj. Butorphanol 0.02 mg/kg. Both groups received an infusion of inj. Dexemetomidine @ 0.2 mcg/kg/hr. All patients were assessed for intraoperative haemodynamic changes, SpO2, respiratory rate, Ramsay sedation score(RSS), and visual analogue scale(VAS).Rescue doses of sedatives, analgesics, satisfaction scores(Patients and Surgeons) were compared in both the groups. Data was analyzed using chi-square and t-test. p value