Provide Oligaemic Surgical Field during Middle Ear Surgery under General Anaesthesia

What is it about?

Provide Oligaemic Surgical Field during Middle Ear Surgery under General Anaesthesia

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Photo by Mark Paton on Unsplash

Photo by Mark Paton on Unsplash

Why is it important?

Introduction: Middle ear surgeries require hypotensive anaesthesia to improve quality of surgical field. Dexmedetomidine is α2 agonist which provides desired surgical field, sedation and analgesia. Aim: The present study was aimed to evaluate the effects of dexmedetomidine infusion on requirement of halothane to provide oligaemic surgical field during middle ear surgery using operating microscope. Materials and Method: 90 patients of either sex between age group of 18-60 years, ASA grade I and II were randomly divided into two equal group scheduled for Middle Ear Surgery were included in this observational study. Patients of group I were given placebo infusion of normal saline and group II given inj.dexmedetomidine at rate of 1 µ g/kg i.v over 10 min 15 min before induction followed by infusion at 0.4 µ g/kg/hr i.v till 10 min prior to end of surgery. General anaesthesia given with standard anaesthetic technique. Halothane concentration was titrated to achieve mean arterial pressure 30% below baseline value. All patients assessed intra‑operatively for bleeding at surgical field, haemodynamic changes and awakening time. Result: Mean percentage of halothane requirement to maintain mean arterial blood pressure below 30% of baseline value was significantly reduced in patients receiving dexmedetomidine infusion (0.34±0.2%) when compared to those receiving placebo infusion (0.54±0.3%). Quality of surgical field was better and mean awakening time was significantly reduced in Group II than Group I (<0.001). Conclusion: Dexmedetomidine infusion maintains hemodynamic stability and was safe to provide oligaemic surgical field for better visualisation under operating microscope for middle ear microsurgery.

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