ABSTRACT : The aim of our study is to evaluate the optimum dose of dexmedetomidine which provide better procedural sedation. Peri-operative hemodynamic changes, intra-operative adjuvant drug requirement and post-operative recovery were also compared in three different groups of dexmedetomidine.

METHODS : This randomized controlled trial wascarried out in 120 patients of ASA grade I and II in age group 18 – 45 years undergoing short gynaecological procedures in Lady Hardinge Medical College and associated hospitals. Patients were randomly allocated into three groups of 40 each. Group A received dexmedetomidine infusion at the rate of 0.2µg/kg/hr, Group B at the rate of 0.4µg/kg/hr and Group C at the rate of 0.6µg/kg/hr after a loading dose of 1µg/kg/hr over 10 minutes.

RESULTS : Heart rate, Blood pressure, oxygen saturation and respiratory rate remained within normal physiological range in all the three groups at most of the time points intra and post-operatively. Time to achieve Modified aldrete score and Postanesthetic discharge scoring system was maximum in group C and minimum in group A. ketamine had to be supplemented in almost half of patients in group A and less than quarter patients in group B. In group C, surgery was completed without any drug supplementation. 2 patients in group B and 4 patients in group C had an episode of bradycardia. Oxygen saturation decreased only in 1 patient in group C which required oxygen supplementation.

CONCLUSIONS : We concluded that dexmedetomidine in a dose of 0.4µg/kg/hr seem to be most appropriate for procedural sedation and analgesia