Effects of dexmedetomidine infusion in patients undergoing functional endoscopic sinus surgery under local anaesthesia.
OBJECTIVE
Functional endoscopic sinus surgery can be performed under either local or general anaesthesia. The objective of this study was to investigate the haemodynamic effects of perioperatively administered dexmedetomidine, a new generation alpha-2-agonist, in patients for functional endoscopic sinus surgery.


METHODS
Sixty-two patients who were planned to undergo functional endoscopic sinus surgery under local anaesthesia were included in the study. Following meperidine premedication, both groups were monitored in a standard manner with electrocardiogram, non-invasive blood pressure and percentages of peripheral saturation of oxygen. Saline intravenous infusion was started in the placebo group, and dexmedetomidine bolus intravenous infusion (an initial loading dose of 1 microg kg-1 given for a 10-min period followed by 0.7 microg kg-1 h-1) was administered to the treatment group. Maintenance dose infusion was stopped 15 min before the end of the surgical procedure.


RESULTS
Systolic, diastolic and mean arterial pressures, and heart rate markedly decreased in the dexmedetomidine group. However, dexmedetomidine had no effect on serum nitric oxide levels, measured by a nitric oxide/ozone chemiluminescence method. No significant difference was found in oxygen saturation levels of the two groups. Postoperative nausea and vomiting rates were significantly lower in the dexmedetomidine group. No adverse effects were observed with this alpha-2-agonist. Dexmedetomidine provided appropriate levels of sedation.


CONCLUSIONS
These results suggest that dexmedetomidine provides analgesia, adequate sedation and surgical comfort without adverse effects for patients undergoing functional endoscopic sinus surgery under local anaesthesia.
University of Gaziantep, Faculty of Medicine, Department of Anaesthesiology and Reanimation, Gaziantep, Turkey. sitkigoksu@yahoo.com
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Goksu
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Arik
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Demiryurek
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Mumbuc
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Oner
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Demiryurek
D053799:2-Pyridinylmethylsulfinylbenzimidazoles / Q000008:administration & dosage / Q000627:therapeutic use*; D000328:Adult; D000698:Analgesia; D000772:Anesthesia, Local; D001794:Blood Pressure / Q000187:drug effects; D016292:Procedural Sedation / Q000379:methods; D004562:Electrocardiography; D004724:Endoscopy; D006339:Heart Rate / Q000187:drug effects; D006801:Humans; D006993:Hypnotics and Sedatives / Q000627:therapeutic use*; D007262:Infusions, Intravenous; D064747:Lansoprazole; D008875:Middle Aged; D016343:Monitoring, Intraoperative; D009298:Nasal Polyps / Q000601:surgery*; D018579:Patient Selection; D012852:Sinusitis / Q000601:surgery*
D053799:2-Pyridinylmethylsulfinylbenzimidazoles; D006993:Hypnotics and Sedatives; D064747:Lansoprazole