COMPARISON OF DEXMEDETOMIDINE AND FENTANYL-MIDAZOLAM FOR TYMPANOPLASTY UNDER MONITORED ANAESTHESIA CARE

Tympanoplasty surgery can be done under local anaesthesia plus sedation. Materials and Methods: 60 patients undergoing tympanoplasty under local anaesthesia randomly received either IVdexmedetomidine 1 mcg/ kg over 10 min followed by 0.3-0.5mcg/ kg/hour infusion (Group D) or IV midazolam 0.015-0.03 mg/ kg plus IVfentanyl 2mcg/ kg slowly (Group MF). Vital parameters, rescue analgesics fentanyl 20 mcg and midazolam 0.5 mg,patient and surgeon satisfaction scores were recorded Results: Patient and surgeon satisfaction score was better in Group Dexmedetomedine (Group D) than Group Midazolam-Fentanyl (Group MF). Intraoperative heart rate andmean arterial pressure in Group D were lower as compared to Group MF.Patients required more rescue fentanyl or midazolam doses in Group MF than Group D. A few patients in Group D and in Group MF complained of drymouth.One patient in Group D had bradycardia with hypotension which was effectively treated. Conclusion: Dexmedetomidine is preferred for tympanoplasty. Haemodynamics need to be closely monitored.