Background and Aims: Controlled hypotension is required for middle ear surgery to achieve a bloodless operative field. A highly selective alpha2 adrenergic agonist like dexmedetomidine, by virtue of its central sympatholytic, sedative and analgesic-sparing effect may provide such desired operating conditions. The present study was designed to evaluate the clinical effects of dexmedetomidine infusion as an anesthetic adjuvant to provide oligemic surgical field in middle ear surgeries.

Methods: Forty patients of American Society of Anesthesiologists (ASA) physical status I and II, aged 18-58 years, weighing 45-80 kg, scheduled for elective middle ear surgery, were enrolled for this prospective  placebo controlled observational study. After induction of general anaesthesia, Patients of Group A received infusion of dexmedetomidine 0.5 μg/kg/h and patients of Group B received placebo infusion of normal saline during middle ear surgery till 20 min before completion of surgery. All patients were assessed intraoperatively for bleeding at surgical field, haemodynamic changes, awakening time and postoperative recovery.

Results: The mean heart rate was found to be higher in patients of Group B after the extubation while patients of Group A did not show much variation in their mean heart rate values. In Group A, the Bleeding Scores and the Final Opinion on Bleeding Score were significantly lower when compared with Group B. None of the patients of Group B had significant reduction in bleeding at surgical site, thus it is evident that patients receiving dexmedetomidine infusion had a better surgical field as compared to patient of Group B.

Conclusions: Dexmedetomidine was found to significantly reduce intra operative bleeding. This, in turn, improves operative field visibility and increases surgeon’s satisfaction during middle-ear surgery under general anesthesia.

Keywords: Dexmedetomidine, anesthesia oligemic surgical field, Middle ear.

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Dr Junaida Sarwar

Post Graduate Student, Department of Anesthesiology, Govt. Medical, College, Srinagar 190002

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