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To compare the efficacy of dexmedetomidine versus fentanyl as sedative & analgesic in short general anaesthesia in day care obstetrics & gynaecological surgeries

Author: 
Dr. Piyush Kumar Sengar, Dr. Smita Priyadarshini, Dr. Manish Raj and Dr. Pratibha Rai
Subject Area: 
Health Sciences
Abstract: 

Introduction: Dexmedetomidine being a highly selective & potent α2a agonist has a wide therapeutic actions. Dexmedetomidine was used as a sole analgesic & sedative agent in day care surgeries. Methods: The study was conducted on 40 patients divided in 2 groups, A & B of ASA-I & ASA-II. In group A patients received inj. Dexmedetomidine 1 µg/kg i.v slowly & in group B received inj. Fentanyl 1 µg/kg i.v slowly prior to induction. Following preoxygenation induction done with inj. Propofol i.v 2mg/kg & maintained with 33% O2, 66% N2O & 0.6-0.8% of Isoflurane with patient breathing spontaneously. Patients were evaluated in post operative recovery room with help of visual analogue scale for pain, Ramsay score for sedation & Standard Aldrete score for recovery. Results: There were no statistically significant differences in both group’s demographic profile. Comparison of pulse rate in Dexmedetomidine group shows significant fall immediately after premedication but remained equivalent to baseline throughout surgery & significant fluctuation of pulse rate seen in Fentanyl group and this significant difference remain throughout the surgery. Similar results were seen in systolic blood pressure. Statistically highly significantly fall in saturation was observed in fentanyl group. The post operative analgesia duration was more with Dexmedetomidine than Fentanyl. The sedation was highly significant in fentanyl group & the quality of recovery with Aldrete was highly significant in Dexmedetomidine group at 15, 30, 60 minutes. Conclusion: Dexmedetomidine used as a sole sedation / analgesia is not only very effective but produces excellent hemodynamic stability, minimal side effect, prolongs post operative analgesia, early recovery and has no residual CNS depressant effect.

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