To Compare The Efficacy Of Dexmedetomidine-Ketamine Vs Midazolam-Ketamine Combinations For Conscious Sedation In Surgery Done Under Local Anaesthesia

Abstract

Background: This prospective, randomized, double-blind clinical study was conducted to compare the efficacy of dexmedetomidine (Group DX) and midazolam (Group MX) for conscious sedation in minor superficial surgical procedures. The primary objectives were to assess recovery time, analgesic efficacy, and hemodynamic stability.

Methods: Sixty ASA I–II patients aged 20–65 years were randomly assigned to two groups: Group DX received dexmedetomidine 1 mcg/kg IV over 2 minutes followed by 0.5 mg/kg ketamine IV, while Group MX received midazolam 0.05 mg/kg IV over 2 minutes followed by 0.5 mg/kg ketamine IV. Hemodynamic parameters, sedation levels, recovery time, and analgesic requirements were recorded.

Results: The demographic and baseline hemodynamic parameters were comparable between the groups (p > 0.05). Patients in Group DX had a significantly shorter recovery time (7–9 min) compared to Group MX (12–15 min) (p < 0.001). The time to first rescue analgesia was prolonged in Group DX (70 ± 20 min) compared to Group MX (50 ± 10 min) (p < 0.01), indicating better analgesic efficacy. Additionally, the frequency of rescue analgesics was lower in Group DX (p < 0.05). Hemodynamic parameters showed a significantly lower heart rate (50–65 bpm in DX vs. 70–80 bpm in MX, p < 0.001) and lower mean arterial pressure in Group DX (p = 0.02), suggesting greater sympatholytic effects. Oxygen saturation remained stable in both groups (p = 0.75).

Conclusion: Dexmedetomidine provided superior sedation with faster recovery, prolonged analgesic duration, and lower rescue analgesic requirements compared to midazolam. Additionally, it resulted in better hemodynamic stability with significant bradycardia but maintained oxygenation levels. These findings suggest that dexmedetomidine may be the preferred agent for conscious sedation in minor surgical procedures.