A Comparison of Three Drug Combinations for Sedation during Middle Ear Surgeries under Local Anesthesia: A Multicentric Randomized Double Blind Study

Background: During Middle Ear Surgeries (MES) done under Local Anesthesia (LA), patients may feel discomfort due to noise of suction, manipulation of instruments, positioning of head-neck and sometimes due to pain. A bloodless microscopic field is also essential to facilitate surgical exposure in MES. Various combinations of analgesics and sedatives have been tried to alleviate apprehension of the patients and improve microscopic field which may result into reduction in surgical time. In the present study, we have compared Dexmedetomedine (Dex) with Midazolam-Fentanyl (MF) and PentazocinePromethazine (PP) combinations for their sedoanalgesia, anxiolysis and other pharmacological effects when administered during MES, not lasting for more than 60 min. Material and Methods: Ninety American Society of American Society of Anesthesiologists (ASA) group I /II patients admitted in either of the three hospitals during May 2014 to January 2015 for MES under LA were randomly divided into three groups by an independent observer. Group D received intravenous bolus of Injection Dexmedetomidine 1 μg/ kg over 10 min. Group MF received Injection Midazolam 0.06 mg/ kg + Inj. Fentanyl 1 μg/ kg and Group PP received Injection Pentazocine 0.3 mg/kg + Injection Promethazine 0.5mg/kg given intravenously followed by LA before taking incision for the surgery. Need of a rescue sedoanalgesic dose of (Midazolam 0.01 mg/kg + Fentanyl 0.5 μg/kg) during the surgery was noted. All the patients received 500 ml of normal saline infusion A Comparison of Three Drug Combinations for Sedation during Middle Ear Surgeries under Local Anesthesia: A Multicentric Randomized Double Blind Study 1 1* 2 1 2 Vikas Kumar , Jyotsna S. Paranjpe , Shishir D. Gosavi , Ruta H. Kulkarni , Rahul S. Gosavi , 1 Tanuja M. Kulkarni Department of Anaesthesia, Bharati Vidyapeeth Deemed University Medical College & 2 Hospital, Sangli-416416 (Maharashtra) India, Sanjeevan Medical Foundation, Miraj-416410