Comparison of Dexmedetomidine and Midazolam in Sedoanalgesia for Lumbar Facet Radiofrequency Ablation

Abstract

Objectives: Lumbar facet radiofrequency ablation (LFRA) is a painful procedure. Sedation may be applied to improve patient comfort during the procedure; however, deep sedation should be avoided to maintain the patient cooperation. The purpose of this study was to compare dexmedetomidine and midazolam in sedoanalgesia for LFRA. Methods: Patients planning to undergo LFRA were included in this cross-sectional, observational study. After a bolus dose, intravenous infusion of dexmedetomidine was administered in group D, whereas intravenous midazolam was given in group M. Intraoperative vital signs, procedural pain severity (Numerical Rating Scale-NRS), Patient Satisfaction Score (PSS), Operator Satisfaction Score (OSS), and complications were recorded. Results: A total of 96 patients were included in the study. Group D consisted of 47 and group M of 49 patients. Procedural NRS, PSS, and OSS were significantly in favor of group D. Mean procedural NRS of group D was 2.91 +/- 2.03, and 4.14 +/- 2.17 in group M (P=0.005). The rate of unsatisfactory PSS was 1 (2.1%) in group D and 7 (20%) in group M (P=0.03). The rate of unsatisfactory OSS results was 2 (4.2%) in group D and 16 (32.6%) in group M (P<0.001). Although over-sedation and low oxygen saturation were significantly more frequent in group M, hypotension was higher in group D. Discussion: In sedoanalgesia for LFRA, dexmedetomidine is superior to midazolam with lower procedural pain, higher satisfaction scores, and improved patient cooperation. The results of this study can be considered for sedoanalgesia in other interventional pain procedures.