Use of dexmedetomidine in monitored anaesthesia care for burr hole and evacuation of chronic sub-dural haematoma: A comparison with general anaesthesia

Abstract

Background
Burr hole craniotomy surgery is commonly used for evacuation of Chronic sub dural haematoma. Either Local anaesthesia with
sedation or General anaesthesia is used for such cases. Monitored Anaesthesia Care has been advocated as safer tool. Dexmede tomidine has
sedation without respira tory depression, analgesia and sympatholytic effect which make it an attractive agent for sedation during MAC. Methods
T o tal 60 patients were randomized in 2 equal groups: G roup D received a loading dose of 0. 7 mcg/kg of dexmedetomidine over 10 minutes
intravenously followed by a maintenance infusion of 0. 5 mcg/kg/h, infiltration with 2 ml of injection 0.5% bupivacaine and 2 mL of injection 2%
lignocaine at each burr hole site. In G roup G: intubation with balanced general anesthesia given. Results: Mean time to recovery from anesthesia
was less in group D 12.67±3.14 versus 18.40±5.04; p<0.001) but no significant changes in anesthesia onset time, total duration of surgery total
duration of hospital stay.. The hemodynamic changes were significantly more in group G as compared to group D at the time of induction, after
5 minutes of induction and at the time of extubation. Overall postoperative complications were significantly more P = 0.041) in the group G as
compared with group D. Conclusion: U se of dexmedetomidine is effective and safe for surgical evacuation of chronic subdural hematoma via
burr hole craniotomy.