Effect of intraoperative dexmedetomidine infusion during functional endoscopic sinus surgery: a prospective cohort study
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RESEARCH
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Effect of intraoperative dexmedetomidine infusion during functional endoscopic sinus surgery: a prospective cohort study Mohammad Reza Fazel1, Zeynab Sadat Ahmadi2, Hossein Akbari1 and Fahimeh Abam1,2,3*
Abstract Background: Dexmedetomidine, an α2 agonist, has well-known anesthetic and analgesic-sparing effects. We designed this study to evaluate the effect of intraoperative dexmedetomidine infusion on intra operative blood loss and postoperative pain in functional endoscopic sinus surgery. Methods: This prospective cohort study included 90 patients planning to undergo endoscopic sinus surgery, who were randomly divided into three groups. 2 to 2.5 mg/kg of propofol was used in all groups to induce anesthesia. One group received dexmedetomidine 0.2 μg/kg per hour infusion whereas the other group received dexmedetomidine 0.5 μg/kg per hour infusion. The control group received normal saline infusion. Results: The mean age of patients was 41.02 ± 11.93. 33 patients in the dexmedetomidine 0.2 μg/kg/h group, 30 patients in the dexmedetomidine 0.5 μg/kg/h group and 27 patients in the placebo group. The lowest amount of bleeding was related to the dexmedetomidine 0.5 μg/kg/h group. The volume of bleeding between the three groups was significantly different (p = 0.012). The satisfaction of the surgeon in the dexmedetomidine 0.5 μg/kg/h group was more than other groups. There was a significant relationship between the satisfaction of the surgeon and the treatment groups (p < 0.001). The lowest duration of surgery was related to the dexmedetomidine 0.2 μg/kg/h group. The most Trinitroglycerin (TNG) consumption was in the placebo group and the highest dose of labetalol was in the dexmedetomidine 0.5 μg/kg/h group. There was no significant difference in the TNG and labetalol consumption between three groups. The lowest consumption of morphine and pethidine in the dexmedetomidine 0.5 μg/kg/h group. Conclusions: Infusion of dexmedetomidine 0.5 μg/kg/h decreased blood loss and consumption of morphine and pethidine in patients who underwent endoscopic sinus surgery. Keywords: Dexmedetomidine, Functional endoscopic sinus surgery, Pain, Blood loss
Background Rhinostenosis is an inflammatory process of the paranasal sinuses, which is diagnosed based on clinical manifestations, endoscopic findings, and changes in computed tomography (CT) scans [1].. The best treatment is * Correspondence: [email protected] 1 Department of Radiology, Faculty of Medicine, Kashan University of Medical Sciences, Kashan, Iran 2 Research Center of Biochemistry and Nutrition in Metabolic Disorder, Kashan University of Medical Sciences, Kashan, Iran Full list of author information is available at the end of the article
endoscopic sinus surgery [2]. Bleeding is one of the most common problems during the sinus endoscopy. Chronic rupture disrupts the field of surgery and increases the risk of problems such as damage to the skull and eye cavity. Hemorrhage increases the duration of surgery due to several interruptions during surgery
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