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Ab s t r Ac t Objective: To compare the efficacy and safety of dexmedetomidine and propofol for hypotensive anesthesia in ENT surgeries in Indian phenotype. Materials and methods: A prospective, randomized, comparative study. The study population of 72 patients of Indian phenotype were randomly taken from random number table and divided into two groups with 36 patients in each group. Group D = dexmedetomidine (dexmedetomidine loading dose of 1 μg/kg dexmedetomidine diluted in 10 mL 0.9% saline infused over 10 minutes before induction of anesthesia, followed by infusion of 0.2–0.7 μg/kg/hour). Group P = propofol group (maintenance dose 100–150 μg/kg/hour). The infusions were titrated to maintain mean arterial pressure (MAP) between 55 and 65 mm Hg and hemodynamic stability. Results: In our study, we did not have hypotension or bradycardia that needed treatment. The heart rate and blood pressure were on the lower side in group D compared to group P. The awakening time was significantly short in group D than group P. The average doses of dexmedetomidine around 0.2 ± 0.04 μg/kg/hour and propofol around 140 ± 41 μg/kg/hour which are at the lowest end of the recommended doses of 0.2–0.7 μg/ kg/hour and 100–300 μg/kg/hour for hypotensive anesthesia. These low doses may be the cause of no complications in the Indian population. Conclusion: In our comparative study done in Indian population, we observed that both dexmedetomidine and propofol have achieved desired hypotension in patients undergoing ENT surgeries to improve the operative field visibility by reducing the blood loss. Although achieved reduction in MAP was statistically nonsignificant, MAP was lower in dexmedetomidine than propofol. A significantly higher Ramsay sedation score in propofol group is suggestive of greater degree of sedation than dexmedetomidine, making it a better choice for hypotensive anesthesia.

A Comparative Study between Propofol and Dexmedetomidine for Hypotensive Anesthesia in ENT Surgeries in Indian Phenotype