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Background & objective: We studied the safety and effectiveness of combination of dexmedetomidine and fentanyl for chronic sub-dural hematoma (CSDH) evacuation. Main objectives of the study were to register the effects on the combination on the cardio-respiratory and analgesic outcome. Methodology: 56 patients with CSDH were divided into two group. Patients of Group A received dexmedetomidine 1 µg/kg over a period of 10 min with fentanyl 1 µg/kg, followed by an infusion of dexmedetomidine 0.3 µg/kg/min. Group B received fentanyl 1 µg/kg and midazolam 0.03 mg/kg IV. Sedation scores, hemodynamic changes and serial arterial blood gas (ABG) measurements were compared between the two groups. Results: Heart rate and diastolic blood pressure were significantly lower in Group A compared to Group B throughout the observation period after premedication. Systolic blood pressure readings were significantly lower in Group A compared to Group B from 10 min onwards till the end. ABG analysis showed that Group A had significantly lower PCO2 levels during and at the end of surgery and significantly higher PO2 at the end of procedure. Conclusion: The use of dexmedetomidine is associated with significantly higher PO2 at the end of the surgical procedure. It results in lower heart rate, systolic and diastolic blood pressures and PCO2 levels during and at the end of the subdural hematoma evacuation, but the fall remains within the physiological range. [ABSTRACT FROM AUTHOR]

Background: Maintaining arterial partial pressures of carbon dioxide and oxygen within physiological range is very crucial for the better outcome of neurosurgery patients. We studied respiratory effect of dexmedetomidine, fentanyl combination along with infiltration of local anesthesia for chronic SDH evacuation in ASA 2,3 and 4 patients. Material and methods: 56 patients with chronic SDH posted for burrhole evacuation were divided in to 2 groups. Group A received bolus dose dexmedetomidine 1 mcg/kg over 10 minutes in addition to fentanyl 1µgm/kg, midazolam 0.02 mg/kg, followed by infusion of dexmedetomidine 0.3µg/kg/min .group B recieved fentanyl 1 µg/kg, midazolam 0.02 mg/kg. Haemodynamics and artetial blood gas (ABG), between the two groups were compared. Results; Following medication, Partial pressure of carbon dioxide increased from baseline values in both the groups but the increase was significantly less in dexmedetomidine group (P<0.001). Partial pressure of oxygen was significantly high in group A towards the end of study.(P<0.001). There was a significant difference in Ph between the two groups towards the end of study. Conclusion: Pco2 levels were better preserved in Fentanyl, midazolam and dexmedetomidine combination group while Po2 levels were significantly higher in the dexmedetomidine group towards the later part of study. [ABSTRACT FROM AUTHOR]