Efficacy of dexmedetomidine as an anesthetic adjuvant for functional endoscopic sinus surgery under general anesthesia : a randomized-controlled study

Abstract EN

Background Functional endoscopic sinus surgery (FESS) requires effective control of bleeding for better visibility of the operating fi eld and reduced risk of injury to the optic nerve or the internal carotid artery.

Dexmedetomidine can provide controlled hypotension, analgesia, and sedation.

The present study aimed to evaluate the clinical effi cacy, safety, and advantages of dexmedetomidine as an anesthetic adjuvant for FESS.

Patients and methods Fifty adult consented patients of comparable demographic profi le, scheduled for FESS, were assigned randomly to two groups.

Patients of group D received a loading dose of dexmedetomidine 1 μg/kg over 10 min, followed by an infusion at 0.4–0.7 μg/kg/h and patients of group C were administered an identical amount of saline solution.

During the procedure, hemodynamic changes, intraoperative surgical grade of bleeding (on the basis of the Fromme–Boezaart scale), intraoperative fentanyl consumption, emergence time, and total recovery from anesthesia (Aldrete’s score ≥9) were recorded.

Results Patients of group D comparatively had a lower intraoperative heart rate and mean arterial blood pressure, along with a signifi cantly lower bleeding score (P < 0.001).

The mean intraoperative fentanyl consumption was signifi cantly lower in patients of group D.

Emergence time and time to achieve an Aldrete’s score 9 or more were signifi cantly lower in group C at 15 and 30 min postoperatively.

Conclusion Dexmedetomidine has effectively provided the ideal oligemic surgical fi eld during FESS and offers the inherent advantages of analgesia, sedation, and anesthetic-sparing effects.