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Subject Area

Anesthesiology and Intensive Care

Article Type

Original Study

Abstract

Objectives We evaluated different doses of dexmedetomidine to achieve the optimal balance between efficacy and safety. Background Great auricular nerve block can be used for surgical procedures to enhance patient comfort and decrease pain. Dexmedetomidine has been found to significantly prolong the duration of peripheral nerve blocks. Patients and methods A total of 120 adult patients undergoing tympanomastoid surgery were randomized into three equal groups after fulfilling the criteria of the study population. After induction of general anesthesia, great auricular nerve block was done using either 4 ml of 0.25% bupivacaine and 1 ml of normal saline in group I, 4 ml of 0.25% bupivacaine added to 50 μg dexmedetomidine in 1 ml of volume in group II, or 4 ml of bupivacaine 0.25% added to it 1 ml of dexmedetomidine (100 μg) in group III. The visual analog scale in the first 24 postoperative hours was the primary end point. The cumulative consumption of analgesics within the first 24 postoperative hours, the time for the first analgesic request, operative field quality, and postoperative sedation were the secondary outcomes. Results The visual analog scale values were significantly lower in group III compared with groups II and I (P < 0.001). There was a significant reduction in postoperative analgesic requirements in group III compared with groups II and I (P < 0.001). Conclusion A dose of 100 μg perineural dexmedetomidine may represent the optimal balance between efficacy and safety as it improve the analgesic quality of the peripheral nerve block without an obvious adverse effects.

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