Comparison of the effects of remifentanil and dexmedetomidine on surgeon satisfaction with surgical field visualization and intraoperative bleeding during rhinoplasty

We aimed to compare the effect of dexmedetomidine with remifentanil on hemodynamic stability, surgical field quality, and surgeon satisfaction during rhinoplasty. In this double-blind randomized controlled-trial, 60 participants scheduled for rhinoplasty at the Mother and Child Hospital, Shiraz, Ira...

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Published in:BMC anesthesiology 2022-01, Vol.22 (1), p.24-24, Article 24
Main Authors: Jouybar, Reza, Nemati, Maryam, Asmarian, Naeimehossadat
Format: Article
Language:English
Subjects:
Adult
Analgesics, Opioid - pharmacology
Anesthesia
Attitude of Health Personnel
Bleeding
Blood pressure
Comparative analysis
Dexmedetomidine
Dexmedetomidine - pharmacology
Double-Blind Method
Drug dosages
Female
Heart beat
Heart rate
Hemodynamics
Hemorrhage - epidemiology
Humans
Hypnotics and Sedatives - pharmacology
Intraoperative Complications - epidemiology
Intubation
Iran - epidemiology
Job Satisfaction
Male
Pain
Paracetamol
Patient satisfaction
Patients
Plastic surgery
Remifentanil
Remifentanil - pharmacology
Respiration
Rhinoplasty
Rhinoplasty - methods
Suctioning
Surgeons
Surgeons - statistics & numerical data
Surgical outcomes
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description We aimed to compare the effect of dexmedetomidine with remifentanil on hemodynamic stability, surgical field quality, and surgeon satisfaction during rhinoplasty. In this double-blind randomized controlled-trial, 60 participants scheduled for rhinoplasty at the Mother and Child Hospital, Shiraz, Iran, was randomely divided into the dexmedetomidine group (IV infusion of 1 μg/kg dexmedetomidine over 20 min before induction of anesthesia then 0.6 μg/kg/hr. dexmedetomidine from the time of induction until the end of the operation) or in the the remifentanil group (an infusion rate of 0.25 μg/kg/min from the time of anesthesia induction until the end of the operation). Bleeding volume, surgeon satisfaction, postoperative pain (visual analog scale (VAS)), Level of sedation (Richmond Agitation Sedation Scale (RASS)), Patient satisfaction, Vital signs & recovery, and the Aldrete Score (used to discharge the patients from recovery) were measured for all participants. The patients in the dexmedetomidine group had less bleeding (p = 0.047) and shorter time to return of respiration, extubation, and the postoperative recovery time (p 
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In this double-blind randomized controlled-trial, 60 participants scheduled for rhinoplasty at the Mother and Child Hospital, Shiraz, Iran, was randomely divided into the dexmedetomidine group (IV infusion of 1 μg/kg dexmedetomidine over 20 min before induction of anesthesia then 0.6 μg/kg/hr. dexmedetomidine from the time of induction until the end of the operation) or in the the remifentanil group (an infusion rate of 0.25 μg/kg/min from the time of anesthesia induction until the end of the operation). Bleeding volume, surgeon satisfaction, postoperative pain (visual analog scale (VAS)), Level of sedation (Richmond Agitation Sedation Scale (RASS)), Patient satisfaction, Vital signs &amp; recovery, and the Aldrete Score (used to discharge the patients from recovery) were measured for all participants. The patients in the dexmedetomidine group had less bleeding (p = 0.047) and shorter time to return of respiration, extubation, and the postoperative recovery time (p &lt; 0.001). The surgeon satisfaction was higher in the dexmedetomidine group (p &lt; 0.001). Patient satisfaction was significantly different between the two groups (p &lt; 0.001). VAS scores, intaking paracetamol, and RASS score were significantly lower in the remifentanil group (p &lt; 0.001). SBP, DBP, MAP, and heart rate were lower in dexmedetomidine group. Dexmedetomidine was associated with relatively stable hemodynamics, leading to decreased intraoperative bleeding, recovery time, and greater surgeon satisfaction and the level of consciousness in the recovery ward. However, painlessness and patient satisfaction were greater with the use of remifentanil. 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The surgeon satisfaction was higher in the dexmedetomidine group (p &lt; 0.001). Patient satisfaction was significantly different between the two groups (p &lt; 0.001). VAS scores, intaking paracetamol, and RASS score were significantly lower in the remifentanil group (p &lt; 0.001). SBP, DBP, MAP, and heart rate were lower in dexmedetomidine group. Dexmedetomidine was associated with relatively stable hemodynamics, leading to decreased intraoperative bleeding, recovery time, and greater surgeon satisfaction and the level of consciousness in the recovery ward. However, painlessness and patient satisfaction were greater with the use of remifentanil. IRCT20141009019470N112 .</abstract><cop>England</cop><pub>BioMed Central Ltd</pub><pmid>35031005</pmid><doi>10.1186/s12871-021-01546-9</doi><tpages>1</tpages><oa>free_for_read</oa></addata></record>
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subjects Adult
Analgesics, Opioid - pharmacology
Anesthesia
Attitude of Health Personnel
Bleeding
Blood pressure
Comparative analysis
Dexmedetomidine
Dexmedetomidine - pharmacology
Double-Blind Method
Drug dosages
Female
Heart beat
Heart rate
Hemodynamics
Hemorrhage - epidemiology
Humans
Hypnotics and Sedatives - pharmacology
Intraoperative Complications - epidemiology
Intubation
Iran - epidemiology
Job Satisfaction
Male
Pain
Paracetamol
Patient satisfaction
Patients
Plastic surgery
Remifentanil
Remifentanil - pharmacology
Respiration
Rhinoplasty
Rhinoplasty - methods
Suctioning
Surgeons
Surgeons - statistics & numerical data
Surgical outcomes
title Comparison of the effects of remifentanil and dexmedetomidine on surgeon satisfaction with surgical field visualization and intraoperative bleeding during rhinoplasty
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