Abstract
BACKGROUND &AIMS: The purpose of this study was to compare the safety and efficacy of monitored anaesthesia care(MAC)using dexmedetomidine with spinal anaesthesia(SA) using ropivacaine in day care varicose vein surgery in terms of patient satisfaction and postoperative ambulatory and discharge time. METHODS: 64 patients who underwent varicose vein surgery were randomly divided into two groups.GROUP I MAC(n=32) GROUP II SA(n=32).In the MAC group, a loading dose of 1µg/kg dexmedetomidine was administered followed by 0.6µg/kg/min maintainance infusion which was then titrated according to sedation. Fentanyl was given as rescue anagesia. In the SA group ,SAwas given with 10mg of 0.5 % ropivacaine by a median/paramedian approach in L3/L4 interspace with 25G Quincke spinal needle. Patient’s satisfaction to anaesthesia and post operative ambulatory time and discharge time were recorded. RESULTS: Significantly higher verbal numerical rating scale for patient’s satisfaction to anaesthesia’ was observed in patients of Group I as compared to Group II. Ambulatory time was significantly earlier in Group I as compared to Group II .Range of ambulatory time in Group I was 2 to 5 hours while that in Group II was 4 to 6:30 hours . Group I patients were discharged earlier than Group II though significant differences were not found. CONCLUSION: Monitored anaesthesia care using dexmedetomidine with fentanyl as rescue analgesia isa better alternative for day care varicose vein surgery due to its association with better patient satisfaction and early ambulatory time and early discharge compared to spinal anaesthesia using ropivacaine.