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A Comparative Study: Dexmedetomidine/Ketamine versus Propofol/Ketamine Combination for Sedation in Patients Undergoing Dacrocystorhinostomy (DCR) Surgery under Local Anesthesia

Ashraf Darwish, Rehab Sami, Dalia Samir, Osman Hefzi

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Abstract

Objective: The purpose of this study was to compare the effects of dexmedetomidine-ketamine and propofol-ketamine combinations on hemodynamics, respiration, sedation level, and the recovery period in patients undergoing DCR under local anesthesia. Methods: Fifty patients undergoing dacryocystorhinostomy surgery under regional anesthesia were divided into two groups. The first group received Dexmedetomidine plus ketamine (group DK, n = 25. The patients received an infusion of 0.5 ug/kg/h of Dexmedetomidine and 0.5 mg/kg/h of ketamine. The second group received Propofol plus ketamine (group PK, n = 25), the patients received 0.5mg/kg/min of Propofol and 0.5mg/kg/h of ketamine by infusion. Hemodynamic data, respiratory rate, and sedation scores were recorded. Sedation level was titrated to a Ramsay sedation scale (RSS) every 5 minutes. Postoperative Aldrete score recovery time were assessed. Results: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline. The oxygen saturation values of Dexmedetomodine/Ketamine (DK) group were higher than those of Propofol/ Ketamine (PK) group. The respiratory rate values of the Dexmedetomidine/Ketamine (DK) group were higher than those in the Propofol/Ketamine (PK) group. The time required to achieve targeted levels of sedation was significantly longer in the Dexmedetomidine/ ketamine (DK) group. Postoperatively the time to achieve an Aldrete score of 10 was higher in Propofol/Ketamine (PK) group. Conclusion: Dexmedetomidine combination with small-dose of Ketamine may prove to be a valuable adjuvant for sedation in patients undergoing DCR surgery, and it may be a valuable alternative to Propofol/Ketamine combination. (Ashraf Darwish, Rehab Sami Dalia Samir and Osman Hefzi. A Comparative Study: Dexmedetomidine/Ketamine versus Propofol/Ketamine Combination for Sedation in Patients Undergoing Dacrocystorhinostomy (DCR) Surgery under Local Anesthesia. Life Science Journal 2013; 10(3):551-554). (ISSN: 1097-8135). http://www.lifesciencesite.com . 80

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Objective: The purpose of this study was to compare the effects of dexmedetomidine-ketamine and propofol-ketamine combinations on hemodynamics, respiration, sedation level, and the recovery period in patients undergoing DCR under local anesthesia. Methods: Fifty patients undergoing dacryocystorhinostomy surgery under regional anesthesia were divided into two groups. The first group received Dexmedetomidine plus ketamine (group DK, n = 25. The patients received an infusion of 0.5 ug/kg/h of Dexmedetomidine and 0.5 mg/kg/h of ketamine. The second group received Propofol plus ketamine (group PK, n = 25), the patients received 0.5mg/kg/min of Propofol and 0.5mg/kg/h of ketamine by infusion. Hemodynamic data, respiratory rate, and sedation scores were recorded. Sedation level was titrated to a Ramsay sedation scale (RSS) every 5 minutes. Postoperative Aldrete score recovery time were assessed. Results: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline. The oxygen saturation values of Dexmedetomodine/Ketamine (DK) group were higher than those of Propofol/ Ketamine (PK) group. The respiratory rate values of the Dexmedetomidine/Ketamine (DK) group were higher than those in the Propofol/Ketamine (PK) group. The time required to achieve targeted levels of sedation was significantly longer in the Dexmedetomidine/ ketamine (DK) group. Postoperatively the time to achieve an Aldrete score of 10 was higher in Propofol/Ketamine (PK) group. Conclusion: Dexmedetomidine combination with small-dose of Ketamine may prove to be a valuable adjuvant for sedation in patients undergoing DCR surgery, and it may be a valuable alternative to Propofol/Ketamine combination. (Ashraf Darwish, Rehab Sami Dalia Samir and Osman Hefzi. A Comparative Study: Dexmedetomidine/Ketamine versus Propofol/Ketamine Combination for Sedation in Patients Undergoing Dacrocystorhinostomy (DCR) Surgery under Local Anesthesia. Life Science Journal 2013; 10(3):551-554). (ISSN: 1097-8135). http://www.lifesciencesite.com . 80

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Available abstract

Objective: The purpose of this study was to compare the effects of dexmedetomidine-ketamine and propofol-ketamine combinations on hemodynamics, respiration, sedation level, and the recovery period in patients undergoing DCR under local anesthesia. Methods: Fifty patients undergoing dacryocystorhinostomy surgery under regional anesthesia were divided into two groups. The first group received Dexmedetomidine plus ketamine (group DK, n = 25. The patients received an infusion of 0.5 ug/kg/h of Dexmedetomidine and 0.5 mg/kg/h of ketamine. The second group received Propofol plus ketamine (group PK, n = 25), the patients received 0.5mg/kg/min of Propofol and 0.5mg/kg/h of ketamine by infusion. Hemodynamic data, respiratory rate, and sedation scores were recorded. Sedation level was titrated to a Ramsay sedation scale (RSS) every 5 minutes. Postoperative Aldrete score recovery time were assessed. Results: Both groups provided a similar significant reduction in heart rate and mean arterial pressure compared with baseline. The oxygen saturation values of Dexmedetomodine/Ketamine (DK) group were higher than those of Propofol/ Ketamine (PK) group. The respiratory rate values of the Dexmedetomidine/Ketamine (DK) group were higher than those in the Propofol/Ketamine (PK) group. The time required to achieve targeted levels of sedation was significantly longer in the Dexmedetomidine/ ketamine (DK) group. Postoperatively the time to achieve an Aldrete score of 10 was higher in Propofol/Ketamine (PK) group. Conclusion: Dexmedetomidine combination with small-dose of Ketamine may prove to be a valuable adjuvant for sedation in patients undergoing DCR surgery, and it may be a valuable alternative to Propofol/Ketamine combination. (Ashraf Darwish, Rehab Sami Dalia Samir and Osman Hefzi. A Comparative Study: Dexmedetomidine/Ketamine versus Propofol/Ketamine Combination for Sedation in Patients Undergoing Dacrocystorhinostomy (DCR) Surgery under Local Anesthesia. Life Science Journal 2013; 10(3):551-554). (ISSN: 1097-8135). http://www.lifesciencesite.com . 80

Key concepts: Dexmedetomidine, Ketamine, Propofol, Sedation, Medicine, Anesthesia, Heart rate, Hemodynamics

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A Comparative Study: Dexmedetomidine/Ketamine versus Propofol/Ketamine Combination for Sedation in Patients Undergoing Dacrocystorhinostomy (DCR) Surgery under Local Anesthesia — Research Paper | ScholarLens