title: Dexmedetomidine decreases the requirement of ketamine and propofol during burns debridement and dressings.
abstract: OBJECTIVE
  Dexmedetomidine (Dex), a highly selective α2-adrenoreceptor agonist, is used for sedation management in various clinical settings and shows anaesthetic-sparing effect. Our aim was to study the effects of Dex on requirements of propofol, ketamine, and intraoperative haemodynamic variations during burns debridement and dressing changes, and compare its effectiveness and safety with combination of ketamine and propofol.
  
  
  METHODS
  Sixty adult patients posted for elective debridement and dressing were included in the study. Thirty patients received Dex (intramuscular)(IM) 1 μg/kg, 1 h before shifting to the operation theatre while the other thirty did not. Anaesthesia was induced with propofol and ketamine followed by adjusted infusion to achieve a Ramsay Sedation Scale score (RSS) of six in all patients. Intraoperatively haemodynamic parameters were recorded at regular intervals of 5, 15, 30, 45, and 60 min. The mean data between the groups were compared by unpaired t test and medians by Mann-Whitney U test. Within group analysis was performed by using repeated measures ANOVA. P < 0.05 was considered significant.
  
  
  RESULTS
  The dose requirement of ketamine and propofol in Dex group was significantly lower when compared to control group (100.5 ± 17.58 mg vs. 231.5 ± 60.39 mg (P < 0.0001) and 127.7 ± 15.47 mg vs. 254 ± 59.22 mg (P < 0.0001) respectively). Additionally, recovery time was lower in the Dex group as compared to the control group, 9.57 ± 1.50 min vs. 11.53 ± 2.56 min (P = 0.0006). Haemodynamic variations were also significantly lower in the Dex group as compared to the control group.
  
  
  CONCLUSIONS
  Dexmedetomidine (1 μg/kg IM) reduced the requirement of propofol and ketamine, with more stable intraoperative haemodynamics.
authors: Department of Anaesthesiology and Intensive Care, Narayana Medical College and Super Specialty Hospital, ChinthareddyPalem, Nellore, Andhra Pradesh, India.
authors: Prabhavathi
authors: P
authors: Ravipati
authors: Department of Anaesthesiology and Intensive Care, Narayana Medical College and Super Specialty Hospital, ChinthareddyPalem, Nellore, Andhra Pradesh, India.
authors: Pothula Narasimha
authors: PN
authors: Reddy
authors: Department of Anaesthesiology and Intensive Care, Narayana Medical College and Super Specialty Hospital, ChinthareddyPalem, Nellore, Andhra Pradesh, India.
authors: Chaithanya
authors: C
authors: Kumar
authors: Department of Anaesthesiology and Intensive Care, Narayana Medical College and Super Specialty Hospital, ChinthareddyPalem, Nellore, Andhra Pradesh, India.
authors: P
authors: P
authors: Pradeep
authors: Department of Clinical Pharmacology and Clinical Research, Narayana Medical College and Super Specialty Hospital, ChinthareddyPalem, Nellore, Andhra Pradesh, India.
authors: Rama Mohan
authors: RM
authors: Pathapati
authors: Department of Clinical Pharmacology and Clinical Research, Narayana Medical College and Super Specialty Hospital, ChinthareddyPalem, Nellore, Andhra Pradesh, India.
authors: Sujith Tumkur
authors: ST
authors: Rajashekar
keywords: Burns; debridement and dressing of burns; dexmedetomidine; drug combinations; fentanyl; ketamine; propofol