Comparative Studies | Medical Surgical | India | Volume 9 Issue 5, May 2020
A Comparative Evaluation of Dexmedetomidine versus Midazolam-fentanyl for Sedation in Vitreoretinal Surgery under Peribulbar Anaesthesia
Dr. Ramakant Sharma, Dr. Alaka Purohit
Introduction: Midazolam fentanyl (MDZ: FEN) combination is frequently used for intravenous sedation in ophthalmic surgeries in adults. Dexmedetomidine (DEX), is also indicated for procedural sedation. However, it may cause deeper sedation and patient non-coperation at recommended doses. Aims and objectives: To evaluate the efficacy and safety of low dose of i. v. dexmedetomidine (DEX) (0.25 microgm/kg) versus i. v midazolam-fentanyl (MDZ: FEN) (0.5mg/25microgm) for vitreoretinal surgeries under peribular anesthesia in adults. Materials and methods: In a randomized, double-blind, interventional study, 60 patients (30 each group) aged 20-60 years, scheduled for vitreoretinal surgery under peribulbar block were divided equally to receive either iv MDZ: FEN (0.5mg/25microgm) or iv DEX (0.25 microgm/kg) dose over 10 mins. The vital parameters, ramsay sedation score (RSS), surgeon satisfaction score & effect on respiration were noted. Results: The ‘DEX’ group patients had stable haemodynamics, level 3 sedation and surgeon satisfaction score of 2–3 (good to excellent operating conditions) with no respiratory depression. The sedation score (RSS) of 3 was achieved at approx 5.3 minutes in MDZ: FEN group as compared to 11.5 minutes in DEX group (p< 0.001). The intraoperative mean blood pressure was significant higher in MDZ: FEN group at 30 to 75 minutes (p<0.001). The post-operative nausea/vomiting was seen in 20 percent patients in MDZ: FEN group (p<0.023) and none in low dose DEX group which was statistically significant. Conclusion: Low dose inj. DEX (0.25microgm/kg) is an effective alternative to inj MDZ: FEN (0.5mg/25microgm) and provides better (level 3) sedation score and stable haemodynamics, surgeon satisfaction and no post‑operative nausea/vomitting. Hence both drugs are efficacious but low dose DEX is better than MDZ: FEN in the study.
Keywords: vitreoretinal, ophthalmic, dexmedetomidine, peribulbar-block, monitored anaesthesia care MAC
Edition: Volume 9 Issue 5, May 2020
Pages: 1615 - 1621
How to Cite this Article?
Dr. Ramakant Sharma, Dr. Alaka Purohit, "A Comparative Evaluation of Dexmedetomidine versus Midazolam-fentanyl for Sedation in Vitreoretinal Surgery under Peribulbar Anaesthesia", International Journal of Science and Research (IJSR), https://www.ijsr.net/search_index_results_paperid.php?id=SR20526180317, Volume 9 Issue 5, May 2020, 1615 - 1621
Similar Articles with Keyword 'ophthalmic'
Efficacy of a Timely Amniotic Membrane Grafting in a Case of Steven Johnson Syndrome
Gayatri Bhonsale, Ishita Mehta, Mamta Agrawal, Suvarna Kalapad
Ectropion Post Ahmed's Glaucoma Valve Implantation: Case Report
Similar Articles with Keyword 'dexmedetomidine'
Comparative Study of Dexmedetomidine with Pethidine for Assessment of Intraoperative Sedation during Mastoid Surgery
B. P. Manjula, Sowmya N
Randomized Controlled Study of Intravenous Regional Anaesthesia for Forearm & Hand Surgery: Comparison of Lignocaine, Lignocaine with Ketamine & Lignocaine with Dexmedetomidine
Dr. Palak P Sheth, Dr. Viral Shah, Dr. Bhavna Soni