Dexmedetomidine Efficacy in Quality of Surgical Field During Endoscopic Sinus Surgery

• Published in: Iranian journal of otorhinolaryngology 2019-09, Vol.31 (5), p.281-288
• Main Authors: Arman Parvizi, Soudabeh Haddadi, Ali Faghih Habibi, Shadman Nemati, Nikoo Akhtar, Hedieh Ramezani
• Format: Article
• Language: English
• Subjects: dexmedetomidine; fess; functional endoscopic sinus surgery; hemodynamic stability; intraoperative bleeding
• ISSN: 2251-7251; 2251-726X
• DOI: 10.22038/ijorl.2019.35561.2178

Introduction: Blood loss is a common concern during functional endoscopic sinus surgery (FESS). The present study aimed to evaluate the efficacy of dexmedetomidine (DEX) in intraoperative bleeding and surgical field in FESS.   Materials and Methods: This double-blind randomized clinical trial was conducted on 72 patients within the age range of 16-60 years who underwent FESS. The subjects were randomly dividedinto two groups. The DEXgroup received 1 mic/kg DEX in 10 min at anesthesia induction followed by 0.4 to 0.8 mic/kg/hour during maintenance, while the control group received normal saline instead of DEX in bolus with the same volumemaintenance. Heart rate, systolic blood pressure, diastolic blood pressure (DBP),mean arterial pressure (MAP),and opioid requirement were evaluated in the 15th, 30th, 60th, and 90thmin of the induction. The surgeon's assessment of the field during surgery and intraoperative bleeding was also recorded in this study.   Results: The DEX group had lower bleeding scores (P=0.001) than the control group.Surgeon's satisfaction based on a Likert scale (P=0.001) was lower in the control group. The mean of DBP was lower in the DEX group in the 30th(P=0.001), 60th(P=0.001), and 90th(P=0.01) min of the induction. The MAP was lower in the DEX group in the 30th(P=0.015), 60th(P=0.052), and 90th(P=0.046) min of the induction. There were no postoperative adverse effects in the DEX group.   Conclusion: It was observed that DEX improves the quality of the surgical field and hemodynamic stability. In addition, DEX might be safely and effectively used in surgeries in which deliberate hypotension is desirable.