COMPARATIVE STUDY ON THE EFFECTS OF INTRAVENOUS DEXMEDETOMIDINE VS. MIDAZOLAM FOR SEDATION IN TYMPANOPLASTY UNDER MONITORED ANAESTHESIA CARE
Main Article Content
Keywords
Dexmedetomidine, Midazolam, Tympanoplasty, Monitored Anaesthesia Care, Sedation, Analgesia, Ramsay Sedation Score, Visual Analogue Scale.
Abstract
Background
Tympanoplasty is a common otologic surgery that requires optimal sedation for patient comfort and procedural efficiency. MAC (Monitored Anaesthesia Care) is often preferred over general anaesthesia due to its benefits, including reduced recovery time, cost-effectiveness, and fewer systemic complications. This study compares the sedative effects, analgesic efficacy, and safety profile of dexmedetomidine and midazolam in patients undergoing tympanoplasty under MAC.
Methods
A double-blind, randomized clinical trial was conducted on 50 patients (ASA grade 1-3) aged 18-60 years undergoing tympanoplasty under MAC. Patients were divided into two groups: Group D received dexmedetomidine (1 µg/kg IV over 15 min, followed by 0.5 µg/kg/hr), and Group M received midazolam (0.05 mg/kg IV, followed by 0.01 mg/kg/hr). Sedation levels were assessed using the RSS (Ramsay Sedation Score), pain was measured using the VAS (Visual Analogue Scale), and hemodynamic parameters were monitored intraoperatively. Patient and surgeon satisfaction scores were also recorded.
Results
Patients in Group D achieved a significantly higher sedation level (RSS ≥3) earlier than Group M, reducing the need for additional sedation. Dexmedetomidine also provided prolonged analgesia, delaying the requirement for rescue analgesia compared to midazolam. Group D exhibited more stable hemodynamic parameters, with lower incidences of tachycardia and hypertension. Postoperatively, patient and surgeon satisfaction scores were higher in Group D, with fewer reported adverse effects.
Conclusion
Dexmedetomidine is a superior sedative agent compared to midazolam for tympanoplasty under MAC. It provides effective sedation, better analgesia, and hemodynamic stability with fewer complications. Its use can enhance patient comfort and improve surgical outcomes in procedures requiring MAC.
References
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Dr. Bethan Olive Varughese
Assistant Professor, Department of Anaesthesiology, M.G.M. Medical College, Nerul, Navi Mumbai, Maharashtra, India.
Dr. Nehal Chandra
Assistant Professor, Department of Anaesthesiology, Terna Medical College, Nerul, Navi Mumbai, Maharashtra, India.
Dr. Dhruvikkumar Vhanesha
Assistant Professor, Department of Anaesthesiology, C.U. Shah Medical College, Surendranagar, Gujarat, India.
Dr. Jaydev Dave
Professor, Department of Anaesthesiology, Shri M.P. Shah Medical College, Jamnagar, Gujarat, India.