Comparison of two different maintenance dose of dexmedetomidine in monitored anesthesia care for surgical procedures under local anesthesia: A prospective and randomized study

Abstract

Dexmedetomidine a novel αagonist is replacing the conventional sedative agents. Monitored Anesthesia Care has a gained lot of popularity in local surgery and high risk procedures. There is no dictum on use of standard fix maintenance dose of dexmedetomidine. The main objective and aim of our study was to find a better maintenance dose of Dexmedetomidine after a fixed loading dose with stable hemodynamic, good satisfaction scores, minimal side effects and less rescue drug consumption. After ethical committee approval our randomized, prospective double blinded study a total 70 patients ASA I-III aged 18-65 years divided into two groups: both groups received a loading dose of 1 µg /kg over 10 minutes followed by group A receiving 0.2 µg/kg/hr and group B receiving 0.4 µ/kg/hr till end of surgery. Patient and surgeon satisfaction evaluated by Likert scale and sedation by Ramsay sedation score and vital parameters recorded. The results were comparable in terms of mean blood pressure, heart rate, SpO, respiratory rate, pain scores and demographic data. Surgeon satisfaction was higher in group B with statistical significance(p<0.001) compared to group A. Mean sedation score at 30 minutes of infusion was 2.63±0.49 in group A and 3.00±0.00 in group B (p value<0.007). Dexmedetomidine maintenance of 0.4 µg/kg/hr is equally safe and effective compared to 0.2 µg/kg/hr but former has better surgeon satisfaction with quicker achievable target sedation. Thus Dexmedetomidine 0.4 µg/kg/hr has a better edge for maintenance.