ORIGINAL ARTICLE   

Otorinolaringologia 2020 September;70(3):80-5

DOI: 10.23736/S0392-6621.20.02244-4

Copyright © 2020 EDIZIONI MINERVA MEDICA

lingua: Inglese

The effects of intravenous propofol and dexmedetomidine on sedation characteristics, hemodynamics, respiratory function and pain in patients undergoing maxillofacial surgery

Mohammad J. FOROUZANMEHR, Abbas A. DELAVARI ✉, Alireza JALALI FARAHNI, Gholam A. NAJAFZADEH

Trauma Research Center, Baqiyatallah University of Medical Science, Tehran, Iran

BACKGROUND: Propofol and dexmedetomidine have been widely used for monitored anesthesia care, the aim of this study compare the effects of intravenous propofol and dexmedetomidine on sedation characteristics, hemodynamics, respiratory function, pain score, patient and surgeon satisfaction in patients undergoing maxillofacial and otolaryngeal surgery.
METHODS: In this clinical randomized study, fifty patients with American Society of Anesthesiologists (ASA) class I-II who were candidates for tympanoplasty or maxillofacial surgery with sedation and local anesthesia were divided into two groups, group D (N.=25) received dexmedetomidine 1 µg/kg/10 min of loading dose followed by 0.4 µg/kg/hour infusion. Group P (N.=25) received propofol 75 µg/kg/min for 10 minutes loading dose followed by 50 µg/kg/min infusion during the operation. After achieving a Ramsay sedation score of 3 operative fields was infiltrated with lidocaine 2% and 1:80,000 epinephrine and the surgery was started. The vital parameters such as heart rate, respiratory rate, systolic blood pressure, diastolic blood pressure, mean arterial pressure and SpO2 were monitored at regular intervals. Patient sedation score, patient’s pain score, patient and surgeon satisfaction score were also recorded.
RESULTS: Propofol and dexmedetomidine provide adequate and comparative sedation, but patients in the propofol group needed more analgesic drugs (P=0.004). Patients satisfaction were significantly higher in the dexmedetomidine group (P=0.004). The systolic blood pressure, diastolic blood pressure, mean arterial pressure, and heart rate during surgery and recovery in dexmedetomidine group were significantly lower than those of the propofol group, but there was no statistical difference in the hypotension and bradycardia.
CONCLUSIONS: The dexmedetomidine is an appropriate sedative and comparable to propofol; the dexmedetomidine has better satisfaction and reduce analgesia, it seems to be in most cases a suitable alternative to propofol, which is the most commonly used drug for sedation.

KEY WORDS: Dexmedetomidine; Propofol; Sedation