Effectiveness of dexmedetomidine for controlled hypotension in providing optimum surgical conditions for functional endoscopic sinus surgeries: A double-blinded randomized controlled trial

Abstract

Objective: Bleeding resulting in impaired intraoperative visibility and increased risk of injury to vital structures such as optic nerve and internal carotid artery requires effective control with controlled hypotension during functional endoscopic sinus surgeries. Our aim in this study is to assess the effectiveness of dexmedetomidine in reducing blood loss during functional endoscopic sinus surgeries (FESS) when it is used for controlled hypotension. Method: Ninety-two American Society of Anesthsiologists - ASA class I and II patients of comparable demographic profile, scheduled for elective FESS received either injectable dexmedetomidine (1 μk g hr-1) for the first 10 minutes and then 0.5 μ kg hr-1 as infusion (Group A) or equal volume of saline infusion (Group B). The hemodynamic changes, utilization of intraoperative rescue medication, intraoperative blood loss, emergence time, postoperative sedation and pain scores were recorded. Results: Patients in the dexmedetomidine group had a remarkable reduction in blood loss (p=0.000) with lesser intraoperative mean arterial blood pressure, heart rate, better sedation and pain scores postoperatively. The mean intraoperative rescue medication consumption was remarkably higher in patients of group B. Extubation time in group A patients was significantly higher (9.04 minutes) than in group B patients (5.07 minutes) (p=0.000). Conclusion: Dexmedetomidine is an optimal effective agent that reduces blood loss by controlled hypotension during FESS providing ideal surgical field with better sedative and analgesic properties.