Comparison of Tympanoplasty under General Anaesthesia and Monitored Anaesthesia Care with Dexmedetomidine
Comparison of Tympanoplasty under General Anaesthesia and Monitored Anaesthesia Care With Dexmedetomidine
Keywords:
Monitored anaesthesia care, Dexmedetomidine, General anaesthesia, TympanoplastyAbstract
Introduction: Tympanoplasty for the surgical correction of chronic suppurative otitis media is one of the most comman ENT surgical procedures. This surgery can be done both under general anaesthesia and local anaesthesia with sedation. Dexmedetomidine is said to have both analgesic and sedative properties. The aim of this study is to compare the results of monitored local anaesthesia with dexmedetomidine with general anaesthesia in patients undergoing tympanoplasty to find out the better efficacious anaesthesia for this surgery. Methods: 100 patients were planned for tympanoplasty were taken up for this study. 50 patients were operated under general anaesthesia and remaining 50 patients were operated under monitored local anaesthesia with dexmedetomidine. The results were evaluated intraoperatively and postoperatively for duration of surgery, hemodynamic stability and complications. Patient’s and surgeon’s satisfaction was also evaluated. Results: The results showed that there was lesser operating time, lesser complications and more hemodynamic stability in patients operated under monitored anaesthetic care with dexmedetomidine than under general anaesthesia. There was better surgeon and patient satisfaction in dexmedetomidine group and there was no requirement of general anaesthesia afterward. Conclusion: It can be concluded that dexmedetomidine is a safe and effective sedative for tympanoplasty done under monitored local anaesthesia and can be preferred method of choice over general anaesthesia. [Jagruti S NJIRM 2017; 8(4):6-9]
References
2. C.R.Patel, S.R. Engineer, B.J. Shah, S. Madhu; Effect of intravenous infusion of dexmedetomidine on perioperative hemodynamic changes and postoperative recovery: a study with entropy analysis; Indian J Anaesth, Volume 56, Issue 6, 2012, pp. 542-546.
3. H.Ayoglu, O.Yapakaci, M.B. Ugar, et al.; Effectiveness of dexmedetomidine in reducing bleeding during septoplasty and tympanoplasty operations; J Clin Anaesth, Volume 20, Issue 6, 2008,pp. 437-441.
4. Dogan R, Erbek S, Gonencer HH, Erbek HS, Isbilen C, Arslan G. Comparison of local anaesthesia with Dexmedetomidine sedation and general anaesthesia during septoplasty. Eur J Anaesthesiol. 2010;27:960–4.5. Durmus M, But AK, Dogan Z et al. Effect of dexmedetomidine on bleeding during tympanoplasty or septorhinoplasty. Eur J Anaesthesiol 2007; 24: 985-986.
6. Hatem Saber Mohamed, Salah Mostafa Asida, Ossama Hamdi Salman; Dexmedetomidine versus nimodipine for controlled hypotension during spine surgery; Egypt J Anaesth, Volume 29, 2013, pp.325-331.
7. Na HS, Song IA, Park HS, Hwang JW, Do SH, Kim CS. Dexmedetomidine is effective for monitored anesthesia care in outpatients undergoing cataract surgery. Korean J Anesthesiol 2011;61:453-9.
8. Candiotti KA, Bergese SD, Bokesch PM, Feldman MA, Wisemandle W, Bekker AY. Monitored anesthesia care with dexmedetomidine: A prospective, randomized, double-blind, multicenter trial. Anesth Analg. 2010;110:47–56.
9. Goksu S, Arik H, Demiryurek S, Mumbuc S, Oner U, Demiryurek AT. Effects of dexmedetomidine infusion in patients undergoing functional endoscopic sinus surgery under local anaesthesia. Eur J Anaesthesiol 2008; 25: 22-28.
10. Aydil U, Yilmaz M, Akyildiz I, Bayazit Y, Keseroglu K, Ceylan A. Pain and safety in otorhinolaryngologic procedures under local anesthesia. J Otolaryngol Head Neck Surg 2008; 37: 851-855.
