COMPARATIVE EVALUATION OF DEXMEDETOMIDINE AND PROPOFOL INFUSION FOR HYPOTENSIVE ANESTHESIA DURING ACDF SURGERY: A PROSPECTIVE RANDOMIZED TRIAL

Abstract

Background: Intense bleeding during general anesthesia is the major limitation during ACDF surgery. It affects operative eld visibility and increases complications. Hypotensive anesthesia is preferred to improve surgical outcomes. This study aimed to compare the efcacy of Propofol and Dexmedetomidine infusion for hypotensive anesthesia in patients undergoing ACDF surgery. To compare the efcacy and safety of Objective: Dexmedetomidine and Propofol for hypotensive anesthesia in ACDF surgeries. This prospective Materials and methods: randomized trial was conducted in 60 adult patients who were scheduled for ACDF under general anesthesia. Patients were randomly divided into two groups: group P (n = 30) received Propofol infusion of 100-150mcg/kg/min and group D (n = 30) received dexmedetomidine with a loading dose of 1 mcg/kg diluted in 10 mL 0.9% saline to be infused over 10 min after induction, followed by maintenance infusion of 0.4-0.8 mcg/kg/h. The infusions were titrated to maintain mean arterial pressure (MAP) between 60 and 70 mm Hg. Hemodynamic control, Intraoperative blood loss, Quality of the surgical eld and patient recovery were recorded. In our study, the mean arterial pressure and heart rate were signi Results: cantly lower in group D throughout the surgery than in group P. Blood loss was signicantly higher in group P (615.18 ± 18.15 ml) than in group D (480.50 ± 14.50 ml). The Surgical eld visibility was comparable between the groups. The awakening time was signicantly shorter in group D than group P. In our study, we observed that both Dexmedetomidine and Propofol Conclusion: are efcacious and safe for controlled hypotension during ACDF; however, Dexmedetomidine provides better hemodynamic control and is associated with lesser degree of sedation without any signicant adverse effects.