A comparative study of middle ear surgeries under sedation and local anaesthesia with midazolam plus dexmedetomidine versus midazolam plus nalbuphine
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 7, Pages 6746-6751
AbstractBackground: Monitored Anaesthesia Care (MAC) typically involves administration of local anaesthesia in combination with IV sedatives, anxiolytic and/or analgesic drugs. Present study was aimed to compare middle ear surgeries under sedation and local anaesthesia with midazolam plus dexmed versus midazolam plus nalbuphine.
Material and Methods: Present study was a prospective, comparative study conducted in patients 18-60 years age, either gender, ASA Grade I /II, posted for middle ear surgery under Sedation & local anaesthesia. In first group MD, patients received intravenous inj. midazolam 1 mg plus inj. dexmedetomidine 1 ugm /kg bolus and 0.5 ugm kg added in 100 ml NS infusion, given at 0.3 to 0.4 ugm/ min. In second group MN, patients received intravenous inj. midazolam 1 mg plus inj nacphin 10 mg slowly.
Results: Patients were randomly divided in two groups of 30 each. In present study, age, gender, BMI, ASA grade, type of surgeries (Tympanoplasty, mastoidectomy, stapedectomy) & duration of surgery was comparable & difference was not statistically significant. Ramsay Sedation Score (RSS) at 30,40 & 90 minutes was better in MD group as compared to MN group, difference was statistically significant. Visual Analogue Score (VAS) at 20, 30,40, 60 & 90 minutes was better in MD group as compared to MN group, difference was statistically significant. Patient & Surgeon satisfaction score was better in group MD as compared to group MN, but difference was not statistically significant. Conclusion: Dexmedetomidine with midazolam was better than nalbuphine with midazolam, with respect to sedation, analgesic effect, patient & surgeon satisfaction.
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