Dexmedetomidine used to provide hypotensive anesthesia during middle ear surgery
This study was carried out to assess the hypotensive effect of low dose dexmedetomidine (DEX) infusion during middle ear surgery. 42 ASA grades I and II patients of either sex aged 18–45 years undergoing elective middle ear surgery were randomly divided into two groups of 21 each. Group I received placebo bolus and infusion of saline at a rate similar to DEX in Group II. Group II received 10–15 min prior to induction of anesthesia 1 µg/kg IV bolus DEX diluted in 10 ml of normal saline over 10 min. Immediately thereafter an infusion of 0.4 µg/kg/hr of DEX commenced. Standard anesthetic technique was used. Halothane was titrated to achieve a mean arterial pressure 30% below the control value (value taken just after premedication). We observed that a statistically significant reduction in the percentage of halothane required to reduce MAP 30% below control value occurred in patients receiving DEX infusion (1.3 ± 0.4%) in comparison to those receiving placebo (3.1 ± 0.3%). Patients receiving DEX infusion had a better surgical field. The mean awakening time was significantly reduced in patients of Group II (9.1 ± 2.7 min) when compared to patients of Group I (12.8 ± 2.2 min).
We conclude that DEX can be safely used to provide hypotensive anesthesia during middle ear surgery.
KeywordsDexmedetomidine Hypotensive anesthesia Middle ear surgery
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- 2.Fairbairn ML, Eltringham RJ, Young PN and Robinson JM (1986) Hypotensive anesthesia for microsurgery of the middle ear. A comparison between isoflurane and halothane. Anesthesia 41:637–640Google Scholar
- 6.Ulger MH, Demirbilek S, Koroglu A, Borazan H and Ersoy MO (2004) Controlled hypotension with dexmedetomidine for middle ear surgery. J Inonu Univ Med Fac 11:4Google Scholar
- 8.Khan ZP, Munday IT, Jones RM, Thornton C, Mant TG and Amin D (1999) Effects of Dexmedetomidine on isoflurane requirements in healthy volunteers. Pharmacodynamic and pharmacokinetic interactions. Br J Anaesth 83:372–380Google Scholar
- 9.Raul A, Vega S, Carolina C, Silvia S, Elba B and Victoria D (2005) Dexmedetomidine: A New Alpha-2 agonist anesthetic agent in infusion for sedation in middle ear surgery with awake patient. Anesthesiology 103:623Google Scholar
- 11.Curtis FG, Castiglia YMM, Stolf AA, Ronzella E, Vani SMD, Nascimento Jr P (2002) Dexmedetomidine and Sufentanil as Intraoperative Analgesics. Comparative study. Rev Bras Anestesiol 52:525–534Google Scholar