ESMOLOL AND DEXMEDETOMIDINE FOR CONTROLLED HYPOTENSION IN MIDDLE EAR SURGERIES - A PROSPECTIVE, OPEN-LABELED, SINGLE-CENTER STUDY

Objective and background- For providing the bloodless surgical field, blood transfusions and reduce the bleeding, controlled hypotension has been used. A central α-2 adrenergic, dexmedetomidine and cardioselctive beta-blocker, esmolol can cause controlled hypotension. The main objective of this study is to analyze the effect of esmolol and compare it with dexmedetomidine for inhalation agent requirement, induction agent’s doe requirements, controlled hypotension, middle ear surgeries and surgical field. Methodology- This is a single center, open-labeled and prospective study. From Quaid-e-Azam medical College Bahawalpur, 100 patients of anesthesiologist’s physical status were selected who were scheduled for the surgeries of middle ear. All the patients were divided into 2 group including 50, 50 patients randomly. One group received dexmedetomidine infusion and other received esmolol infusion. Results- Both groups had the results which were comparable in surgical field assessment and hemodyamic parameters. In Group A which got dexmedetomidine infusion the requirement of thiopentone dose was 494 ± 12.93mg whereas in group B who received esmolol infusion this requirement was 354.50 ± 17.26 mg. In Group A mean concentration of isoflurane was 13.79 ± 4.51 ml and in Group B it was 45.30 ± 5.85 ml. In Group A the requirement of vecuronium was 4.58 ± 0.46 mg whereas in Group B it was 11.19 ± 0.71mg. Conclusion- These drugs reduce the response of pressor equally, provide good surgical field and controlled hypotension. Moreover, the dose requirement of skeletal muscle relaxant, inhalation agent and induction agent can be reduced by dexmedetomidine. Keywords: Middle ear surgery, dexmedetomidine, esmolol, controlled hypotension