Comparing the Efficacy of Dexmedetomidine Administered as an Intravenous Infusion and Intravenous Bolus on Hemodynamic Stability of Patients Undergoing Ear, Nose, and Throat Surgeries.

Abstract

Background and aims: Dexmedetomidine has been administered as an intravenous infusion for maintenance dose following a loading dose, however, there is no study conducted so far that has compared the effectiveness of dexmedetomidine administered as bolus intravenously. The study aimed to compare the hemodynamic stability between intravenous infusion and intravenous bolus injection dexmedetomidine.

Methodology: A comparative observational study was conducted among 60 participants aged 20-60 years with American Society of Anesthesiologists physical status I/II, scheduled to undergo elective ear, nose, and throat surgeries. Participants were divided into Group A (received a loading dose of 0.5 μg/kg followed by 0.3 μg/kg/h intravenous infusion of dexmedetomidine) and Group B (an intravenous bolus of dexmedetomidine 0.5 μg/kg) 15 min before the induction of anesthesia. Hemodynamic variables, anesthetic requirement, blood loss, volume of intravenous fluid, recovery time, pain scores, rescue analgesia required, and any adverse events were recorded.

Results: Heart rate, blood pressure (BP), and mean arterial pressure were found to be significantly higher among participants receiving dexmedetomidine in the bolus group (P = 0.001). Diastolic BP was higher 90 min after intubation. Mean propofol administered, total blood loss, and total intravenous fluid volume were significantly higher in the bolus group (P = 0.001). Pain scores were higher in the bolus group after 2 h and infusion group after 12 h. Participants in the infusion group took more time to recover from anesthesia.

Conclusion: Almost all outcome variables were significantly higher among the bolus group. The recovery time was nonetheless reduced. There were no adverse events reported in both groups.