Purpose:
To compare the efficacy of dexmedetomidine (dex) vs. propofol (prop) in vitreoretinal surgery under local block.
Methods:
An IRB approved double-masked, prospective study with enrollment goal of 200 eyes. Enrollment criteria include subjects between ages 18 and 65 years, ASA 1-3, with good liver and renal function. Patients are randomized into group P (prop) and group D (dex). Group P receives a of 1 mg/kg of prop intravenously (IV) followed by an infusion of 25-100 ug/kg/min. Group D receives a bolus of 0.5 ug/kg IV of dex followed by an infusion of 0.2-0.7 ug/kg/hr. T-test and Mann-Whitney test were used for statistical analysis.
Results:
20 patients have been enrolled; 12 - group P, 8 - group D. Comparisons of parameters are outlined below.
Patient satisfaction was defined 1=very dissatisfied and 5=very satisfied with a mean of 4.8±0.4 in group P and 4.8±0.5 in group D. Surgeon satisfaction was defined 1=very poor and 5=excellent with a mean of 4.7±0.7 for group P and 5.0±0 for group D.
Conclusions:
In the 20 patients recruited, dex has provided adequate sedation, patient and surgeon satisfaction, and hemodynamic stability, with no difference in incidence of adverse effects compared to prop. The only significant parameters between groups P and D were in the PACU, group D patients’ HR and systolic BP. No patients in group D needed rescue medication for bradycardia or hypotension and no one required hospitalization. The mean patient and surgeon satisfaction was between good and excellent in both groups.
Clinical Trial:
http://www.clinicaltrials.gov NCT01001429
Keywords: vitreoretinal surgery • retinal detachment