COMPARISON EFECTIVENESS OF DEXMEDETOMIDINE VERSUS DEXMEDETOMIDINE WITH KETAMINE FOR TYMPANOPLASTY SURGERY DONE UNDER MONITOREDANAESTHESIA CARE

Background: Monitored Anaesthesia Care (MAC) has been widely used for patients undergoing middle ear surgeries. The use of dexmedetomidine in middle ear surgeries as a sole anaesthetic agent had many disadvantages owing to its insufficient sedative effect, increased recovery time and haemodynamic instability. Aims and objectives: To evaluate the effectiveness of dexmedetomidine and ketamine combination in comparison with dexmedetomidine alone for tympanoplasty surgery under MAC. Materials and Methods: In this cross sectional observational study, a total of 100 patients were included. Before the surgery, group D received 1 μg/kg dexmedetomidine followed by infusion of 0.2μg/kg/h to maintain 2 or 3 of modified observers assessment of analgesia and sedation score. The patients in group DK received 1 μg/kg dexmedetomidine followed by infusion of 0.2μg/kg/h plus ketamine 0.5mg/kg 10 minutes before the start of the procedure. Results: In the present study total of 100 patients were included, among which 66.0% were females and 34.0% were males. The mean age of 100 patients was 38.3±11.34 years. There were no differences in baseline measurements of HR, SBP and DBP between the two groups, but Group DK had significant fall in heart rate (5-10%) (P < 0.001). Average patients and surgeons satisfaction with sedation and analgesia was higher in Group DK than Group D (P = 0.001). Conclusion: Dexmedetomidine and ketamine combination provides good haemodynamic stability, higher sedation score with safe and effective method of anaesthesia that provides good MAC for patients undergoing tympanoplasty surgery.