Comparison of Sedation with Dexmedetomidine Alfentanil Versus Ketamine-Alfentanil in Patients Undergoing Closed Reduction of Nasal Fractures

Abstract

Objectives: To compare the sedative effects of dexmedetomidine alfentanil versus ketamine-alfentanil in patients undergoing closed reduction of nasal fractures on the basis of intraoperative hemodynamic changes, satisfaction of patients and surgeons, and the adverse effects.

Methods: Sixty patients with ASA class 1 or 2 were randomized to either of two groups, a dexmedetomidine alfentanil group (DA group; n = 30) or a ketamine-alfentanil group (KA group; n = 30). Hemodynamic parameters, oxygenation status, adverse events, the satisfaction of patients and surgeons, and postoperative pain scores by visual analog scale (VAS) were recorded at specific time intervals during the trial.

Results: Systolic blood pressure was significantly lower in the DA group than in the KA group from T1 min to T15 min. The duration of the recovery ward stay was longer in the DA group; however, two groups were similar in terms of total anesthesia time and awakening time. Likewise, two groups were similar in terms of the patient and surgeon's satisfaction, pain scores, and the occurrence of adverse effects.

Conclusions: Both sedation methods were safely performed, and dexmedetomidine-alfentanil is as effective as ketamine-alfentanil in patients undergoing short-term operations such as nasal fracture corrections.

Keywords: Alfentanil; Dexmedetomidine; Ketamine; Nasal Fracture.

Figure 1.. Changes in hemodynamic variables. Data are shown as mean. DA: dexmedetomidine- alfentanil, KA: ketamine-alfentanil. T0: baseline, T1, T5, and T15: 1, 5, and 15 min after drug infusion in both groups, Trecov: at the recovery ward, T2h, and T6h: 2 and 6 hours after infusion.

Figure 2.. Changes in peripheral oxygen saturation (SpO₂). Data are shown as mean DA: dexmedetomidine- alfentanil, KA: ketamine-alfentanil. T0: baseline, T1, T5, and T15: 1, 5 and 15 min after drug infusion in both groups, T recov: at the recovery ward, T2h, and T6h: 2 and 6 hours after infusion.