Objective: This investigation aims to compare fentanyl with Dexmedetomidine as regards:
1. Their efficacy 2. Provide better quality of surgical field during cochlear implantation, including deliberate
hypotension.
3. The effect of both medications on postoperative pain.
4. Recovery time.
5. Emergence agitation. Patients and Methods:
The study was undertaken following the agreement of the Ethical Committee of Sohag University Hospital
and the acquisition of informed consent from the patient's parents.
Fifty juvenile patients (ASA I or II) scheduled for cochlear implantation were classified randomly into the
dexmedetomidine (D) and the fentanyl (F) groups. Anesthesia was initiated in group (D) with an intravenous
bolus of dexmedetomidine at a dosage of 2 µg/kg, administered slowly over 10 min, then a continuous
infusion at a rate of 0.7 µg/kg/h was conducted until the conclusion of the procedure. In the (F) group,
anesthesia was initiated by an intravenous administration of fentanyl at a dosage of 1 µg/kg over 10 minutes,
then a continuous infusion was conducted at a rate of 0.1 mg/kg/h. Subsequently, I.V. propofol and
atracurium are administered to both groups. We compared the two groups on a number of metrics, including
surgical field quality, intraoperative hemodynamics, recovery and discharge timelines, objective pain levels
after surgery, and the need for rescue analgesics and anti-emetics in the post-anesthesia care unit (PACU).
Results: The D group had a marginal reduction in heart rate (HR) compared to the fentanyl group. These
parameters were significantly reduced in the D group relative to the baseline throughout the operation. The
Modified Aldrete Score is superior in the D group compared to the F group.
A significant variation existed between both groups concerning the objective pain score. A significant
disparity existed between the two groups, with Group D exhibiting a more expedited recovery period
compared to Group F, rendering the data meaningful.
Conclusion: The infusion of dexmedetomidine during cochlear implantation in young individuals was more
effective in causing controlled hypotension. It facilitated swift recovery from anesthesia and diminished the use of analgesics in the PACU.