Dexmedetomidine vs. Fentanyl-Midazolam Combination to Mitigate the Stress Response in Microlaryngoscopy: A Randomized Double-blind Clinical Trial

Background: Laryngoscopy is the most painful noxious stimulus during anesthesia and surgery. Dexmedetomidine increasingly used as a sedative in surgeries involving microlaryngoscopy. Objectives: This study aimed to evaluate effect of dexmedetomidine combination fentanyl midazolam on mitigating stress response patients scheduled for Methods: randomized, double-blind clinical trial enrolled 60 (28 males 32 females) aged 18 - 65 years with American Society Anesthesiologists (ASA) physical status I III. The were microlaryngoscopy equally divided into 2 groups. Group D received 1 μg/kg saline bolus dose over 10 minutes before general (GA) induction, followed by 0.5 μg/kg/h infusions after GA induction. MF 0.8 plus 0.05 mg/kg mg/kg/h an infusion. heart rate (HR) mean arterial blood pressure (MAP) recorded from baseline until end Infusions stopped at Results: number requiring propofol intraoperative supplemental was significantly lower group than MF. (P = 0.022, 0.048, 0.032, 0.045, 0.041, 0.026, 0.030, 0.036) induction surgery; addition, it comparable between both groups MAP all measurements. Conclusions: mitigates hemodynamic changes related more effectively fentanyl-midazolam combination.