Comparative Evaluation the Effect of Intraoperative Infusion of Dexmedetomidine Versus Low Dose Ketamine on Pain and Inflammatory Biomarkers in Patients Undergoing Nasal Surgery

Moustafa, Essam Ali; Ibrahim, Ibrahim Metwaly Bauomy; Aboelsoud, Mohamed Abdelgawad Abdelhalim; Hegazy, Ahmed Gamal Moustafa

doi:10.21608/aimj.2025.446448

Comparative Evaluation the Effect of Intraoperative Infusion of Dexmedetomidine Versus Low Dose Ketamine on Pain and Inflammatory Biomarkers in Patients Undergoing Nasal Surgery

Document Type : Original Article

Authors

¹ Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine for Boys, Al-Azhar University, Cairo, Egypt

² Clinical Pathology, Faculty of Medicine, Al-Azhar University, Cairo, Egypt

10.21608/aimj.2025.446448

Abstract

Background: Maintaining a steady blood pressure and oxygen saturation level in the patient while achieving optimal surgical results is the main goal of anesthesia. Combining general anesthetics with systemic medicines is the goal of current multimodal balanced anesthesia.
Aim and objectives: The purpose of this study is to compare the effects of dexmedetomidine and low-dose ketamine infusion on intraoperative hemodynamic stability, blood loss, perioperative opioid needs, and stress response evaluation as measured by C-reactive protein, blood glucose, and serum levels of cortisol and IL-6.
Patients and methods: From December 2022 through June 2024, 80 patients were included in a prospective, randomized, double-blind, comparative trial at Al-Azhar University Hospitals. A closed opaque envelope containing the patients' allocation code was used to randomly divide them into two equal groups in a parallel way using computer-generated numbers.
Results: At 4h, 8h, 12h, 16h, 20h, and 24h after PACU, there was no significant difference between the two groups on the visual analogue scale (VAS). While both groups' IL-6 levels were similar at baseline, the dexmedetomidine group had considerably lower levels at 6 and 24 hours compared to the ketamine group.
Conclusion: There is no statistically significant difference between dexmedetomidine and low-dose ketamine infusion in terms of the number of adverse events, total dose of morphine used, or time to first request of rescue analgesia for patients having nasal and paranasal sinus surgery in terms of pain management. Ketamine reduces the levels of cortisol and C-reactive protein (CRP) without significantly altering blood glucose levels.

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