Comparison Between Dexmedetomidine and Remifentanil for Controlled Hypotension in Patients Scheduled for Tympanoplasty

Objective: The aim of this study was to compare the effects of an intraoperative infusion of remifentanil and dexmedetomidine on controlled hypotension and recovery time in patients scheduled for tympanoplasty. Material and Methods: In this prospective, randomised, double- blind study, 70 ASA I-II patients aged 18-65 years who underwent tympanoplasty were included. Ten minutes before the induction of anaesthesia, 1 μg/kg remifentanil or 1 μg/kg dexmedetomidine in 100 ml normal saline were administered to patients (Group R (n=35) and Group D (n=35), respectively). Throughout surgery, 0.25-1 μg/kg/dk remifentanil and 0.4-1 μg/kg/h dexmedetomidine infusion were applied to the two groups, respectively. Drug doses were titrated to maintain mean arterial pressure at 60±5 mmHg. Results: While the mean arterial pressure was lower in Group R compared with Group D at induction, and after 10, 20, 30 and 60 min of surgery, it was higher in Group R compared with Group D 5 min after extubation. The number of patients who received additional hypotensive drugs was higher in Group D [Group D=16 (45.7%) and Group R=6 (17.1%)]. Recovery times were similar in both groups. Conclusion: Infusion of remifentanil, at the doses used in this study, was more effective than dexmedetomidine in achieving controlled hypotension.