Title: Dexmedetomidine Versus Nitroglycerine for Controlled Hypotension in Head & Neck Surgery: A Prospective Randomised Clinical Study
Authors: Sanjeev Kumar, Chandrakant Prasad, Saurav Shekhar, Ranjeet Rana De, Rakesh Kumar Singh, K. H. Raghwendra
DOI: https://dx.doi.org/10.18535/jmscr/v5i6.221
Abstract
Aim: Present study is aimed to compare Dexmedetomidine with Nitroglycerine for controlled hypotension in head & neck surgeries in terms of intra-operative blood loss, clearity of surgical field, haemodynamic parameters, post-operative sedation and any adverse events noted.
Materials and Methods: After written informed consent and Institutional Ethical Committee approval, 50 patients were randomly allocated into two groups: Dexmedetomidine (Group D) and Nitroglycerine (Group N). After induction of anesthesia, All patients were initially given loading dose of dexmedetomidine (1 µg kg−1) in group-D and equal volume NS in group-N over a period of 10 minutes. Mean arterial pressure (MAP) of all patients were controlled and maintained between 60-65 mm of Hg by titrated dose of dexmedetomidine (0.4-0.6 µg kg−1h−1) in Group D and Nitroglycerine (0.5-10 µg kg−1) in Group N. Intraoperative blood loss were assessed by surgeon visual bleeding scale and sedation was assessed post operatively in both the groups using Ramsay Sedation score.
Results: Average blood loss in Group D (196.76ml) was significantly less than Group N (232.67ml). Nausea vomiting, tachycardia and shivering were significantly higher in group N where as dryness of mouth and bradycardia was significantly higher in Group D. Sedation score was significantly higher in Group D at 15 mins, 30 mins, 60 mins and 90 mins post-operatively.
Conclusion: Controlled hypotension with dexmedetomidine results in significantly lesser blood loss than with Nitroglycerine, and is associated with prolonged post operative sedation which can be desirable in few patients but leads to increased emergence time.
Keywords- Dexmedetomidine, Nitroglycerine, Head & Neck Surgery, Controlled Hypotension.
