A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries

Background and Aim: Induced hypotension is advantageous in certain types of procedures like endoscopic surgeries in which it establishes a clear surgical field and simultaneously reduces surgical blood loss. The quest for an ideal hypotensive agent still continues in this modern era where many clas...

Full description

Bibliographic Details
Main Authors: Robin Sajan Chacko, K Soundarya Priyadharsini, Mohamed Arif, T Krishna Prasad
Format: Article
Language:English
Published: Wolters Kluwer Medknow Publications 2023-01-01
Series:Archives of Medicine and Health Sciences
Subjects:
Online Access:http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2023;volume=11;issue=1;spage=37;epage=43;aulast=Chacko
_version_ 1797775281220485120
author Robin Sajan Chacko
K Soundarya Priyadharsini
Mohamed Arif
T Krishna Prasad
author_facet Robin Sajan Chacko
K Soundarya Priyadharsini
Mohamed Arif
T Krishna Prasad
author_sort Robin Sajan Chacko
collection DOAJ
description Background and Aim: Induced hypotension is advantageous in certain types of procedures like endoscopic surgeries in which it establishes a clear surgical field and simultaneously reduces surgical blood loss. The quest for an ideal hypotensive agent still continues in this modern era where many classes of antihypertensive drugs are being studied to provide a predictable and safe reduction in blood pressure with least side effect profile. In this study, we aimed to assess the efficacy of dexmedetomidine and labetalol in providing hypotensive anesthesia in patients undergoing ear, nose, and throat surgeries. Materials and Methods: This was a prospective, double-blinded, randomized controlled study. Fifty-eight individuals undergoing ear, nose, and throat surgeries were randomly divided into two groups (Groups A and B). Group A received an intravenous infusion of 0.25 mg/kg of labetalol as a bolus over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 30 mg/h till the end of surgery. Group B received a loading dose of 1 μg/kg of dexmedetomidine intravenously over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 0.4 μg/kg/h till the end of surgery. In both the groups, diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate, and oxy-hemoglobin saturation (SpO2) were recorded. These study variables were recorded before the administration of the study drug, immediately after the administration of the bolus dose of study drug, at the time of induction of anesthesia, immediately after intubation, and then at regular intervals until the end of the surgery. In addition to the abovementioned study, variables blood loss, recovery time, and surgeon satisfaction were also recorded. Results: The heart rate was significantly lower in Group B when compared to Group A at various time intervals. There was no significant difference between the two groups in terms of DBP, SBP, MAP, and SpO2. The blood loss was lesser and the surgeon satisfaction was better in Group B when compared to Group A. The difference in blood loss and surgeon satisfaction was statistically significant between the two groups. However, the recovery time was faster in Group A and the difference was statistically significant. Conclusions: Patients in both the groups showed a reduction in blood pressure, but dexmedetomidine was associated with greater reduction in heart rate, lesser blood loss, and more surgeon satisfaction, whereas labetalol was associated with faster recovery from anesthesia.
first_indexed 2024-03-12T22:33:26Z
format Article
id doaj.art-5438293a136048d9971844d83d26cf3f
institution Directory Open Access Journal
issn 2321-4848
language English
last_indexed 2024-03-12T22:33:26Z
publishDate 2023-01-01
publisher Wolters Kluwer Medknow Publications
record_format Article
series Archives of Medicine and Health Sciences
spelling doaj.art-5438293a136048d9971844d83d26cf3f2023-07-21T14:21:31ZengWolters Kluwer Medknow PublicationsArchives of Medicine and Health Sciences2321-48482023-01-01111374310.4103/amhs.amhs_34_23A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeriesRobin Sajan ChackoK Soundarya PriyadharsiniMohamed ArifT Krishna PrasadBackground and Aim: Induced hypotension is advantageous in certain types of procedures like endoscopic surgeries in which it establishes a clear surgical field and simultaneously reduces surgical blood loss. The quest for an ideal hypotensive agent still continues in this modern era where many classes of antihypertensive drugs are being studied to provide a predictable and safe reduction in blood pressure with least side effect profile. In this study, we aimed to assess the efficacy of dexmedetomidine and labetalol in providing hypotensive anesthesia in patients undergoing ear, nose, and throat surgeries. Materials and Methods: This was a prospective, double-blinded, randomized controlled study. Fifty-eight individuals undergoing ear, nose, and throat surgeries were randomly divided into two groups (Groups A and B). Group A received an intravenous infusion of 0.25 mg/kg of labetalol as a bolus over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 30 mg/h till the end of surgery. Group B received a loading dose of 1 μg/kg of dexmedetomidine intravenously over a period of 10 min before induction of anesthesia and it was followed by a maintenance infusion of 0.4 μg/kg/h till the end of surgery. In both the groups, diastolic blood pressure (DBP), systolic blood pressure (SBP), mean arterial pressure (MAP), heart rate, and oxy-hemoglobin saturation (SpO2) were recorded. These study variables were recorded before the administration of the study drug, immediately after the administration of the bolus dose of study drug, at the time of induction of anesthesia, immediately after intubation, and then at regular intervals until the end of the surgery. In addition to the abovementioned study, variables blood loss, recovery time, and surgeon satisfaction were also recorded. Results: The heart rate was significantly lower in Group B when compared to Group A at various time intervals. There was no significant difference between the two groups in terms of DBP, SBP, MAP, and SpO2. The blood loss was lesser and the surgeon satisfaction was better in Group B when compared to Group A. The difference in blood loss and surgeon satisfaction was statistically significant between the two groups. However, the recovery time was faster in Group A and the difference was statistically significant. Conclusions: Patients in both the groups showed a reduction in blood pressure, but dexmedetomidine was associated with greater reduction in heart rate, lesser blood loss, and more surgeon satisfaction, whereas labetalol was associated with faster recovery from anesthesia.http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2023;volume=11;issue=1;spage=37;epage=43;aulast=Chackoblood pressurecontrolled hypotensiondexmedetomidinelabetalol
spellingShingle Robin Sajan Chacko
K Soundarya Priyadharsini
Mohamed Arif
T Krishna Prasad
A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries
Archives of Medicine and Health Sciences
blood pressure
controlled hypotension
dexmedetomidine
labetalol
title A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries
title_full A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries
title_fullStr A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries
title_full_unstemmed A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries
title_short A randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear, nose, and throat surgeries
title_sort randomized control trial to compare the efficacy of dexmedetomidine and labetalol for induced hypotensive anesthesia in ear nose and throat surgeries
topic blood pressure
controlled hypotension
dexmedetomidine
labetalol
url http://www.amhsjournal.org/article.asp?issn=2321-4848;year=2023;volume=11;issue=1;spage=37;epage=43;aulast=Chacko
work_keys_str_mv AT robinsajanchacko arandomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries
AT ksoundaryapriyadharsini arandomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries
AT mohamedarif arandomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries
AT tkrishnaprasad arandomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries
AT robinsajanchacko randomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries
AT ksoundaryapriyadharsini randomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries
AT mohamedarif randomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries
AT tkrishnaprasad randomizedcontroltrialtocomparetheefficacyofdexmedetomidineandlabetalolforinducedhypotensiveanesthesiainearnoseandthroatsurgeries