Recovery and post-operative analgesic efficacy from fentanyl- versus dexmedetomidine-based anesthesia in head and neck cancer surgery: A prospective comparative trial

BACKGROUND: Opioids such as fentanyl are being used frequently in the management of postoperative period, whereas non-opioid drugs such as dexmedetomidine are now commonly being used as adjuvants during the perioperative period to hasten the fast recovery and better outcome in the post-operative period because of their anesthetic and analgesic property. The recovery profile was measured by the emergence of anesthesia and pain characteristics. We aimed to evaluate and compare the efficacy of dexmedetomidine and fentanyl in the surgery of head and neck cancer patients. METHODS: Prospective double-blind study on 60 patients with the American Society Anesthesiologists (ASA) grade I and II were randomly divided into two groups. Group DM received a loading dose of dexmedetomidine 1 µg/kg over 10 min followed by a maintenance dose of 0.5 µg/kg/h and Group FM received a loading dose of fentanyl 2 µg/kg/h for over 10 min followed by 1 µg/kg/h maintenance dose. Data were analyzed using a Chi-square test or Student’s ‘t’ test. RESULTS: The group DM was hemodynamic stable as compared to group FM. The perturbation during extubation emergence was significantly lower in group DM as compared to that in group FM. A total of four patients were severely agitated in group FM, whereas it was absent in group DM. Severe agitation was significantly different between Group FM and Group DM. The visual analog scale (VAS) was lower among patients of Group DM as compared to Group FM at all times except at 4 h. CONCLUSIONS: The infusion of dexmedetomidine was better in controlling emergence agitation, postoperative pain, and achieving peri-operative hemodynamic stability as compared to fentanyl.