Comparison between sedation and general anesthesia for endoscopic ear surgery

Introduction There are few published articles discussing anesthesia in patients undergoing endoscopic transcanal stapes surgery. In addition, general anesthesia carries a greater cost to the hospital and the patient's recovery in the immediate postoperative period is more symptomatic. Aim This study aims to compare the effectiveness of performing endoscopic ear surgery under sedation using dexmedetomidine and under general anesthesia. The secondary aim is to identify any side effect to the sedation with dexmedetomidine. Patients and methods This is a prospective randomized study comparing two groups of 20 adult patients scheduled for endoscopic transcanal stapes surgery; the surgery in the first group (group I) was performed under sedation with dexmedetomidine and in the second group (group II), surgery was performed under general anesthesia. Both groups received local anesthesia to decrease postoperative pain and to minimize the bleeding. Results There were no operative time differences between both groups, but time in the recovery room was significantly shorter in group I (19.7+-5.4 min) in comparison with group II (30.8+-7.6 min). There were no significant differences in the postoperative complaints between both groups, except for postoperative intubation sore throat, which was not found in the patients with sedation, and postoperative nausea and vomiting, which was statistically significant higher in the patients using general anesthesia 25%. Conclusion We conclude that endoscopic ear surgery may be performed with local anesthesia and sedation using dexmedetomidine in adult patients, with some advantages over general anesthesia (especially in the postoperative period faster recovery and lower incidence of nausea and vomiting), being an option at the time of surgical decision.