Evaluation of outcomes in patients given dexmedetomidine in functional endoscopic sinus surgery.
OBJECTIVE
We aimed to evaluate the effects of dexmedetomidine hydrochloride (DEX) on hemodynamic parameters and on surgeon and patient satisfaction during functional endoscopic sinus surgery (FESS).


METHODS
Forty patients who were to undergo FESS were enrolled in this randomized, prospective, controlled study. In the DEX group, conscious sedation was induced with an infusion of 1 microg/kg of DEX 10 minutes before surgery, followed by an infusion of DEX at 0.2 microg/kg per hour. A control group was given identical amounts of saline solution. During the procedure, hemodynamic data were recorded. The patients evaluated their pain on a visual analog scale (VAS). Intraoperative bleeding was rated on a 6-point scale for evaluation of operative field visibility.


RESULTS
We observed that the DEX group had lower bleeding scores (p = 0.019). The heart rates were lower in the DEX group at the time of induction (p = 0.052) and in the 1st (p = 0.009) and 20th minutes (p = 0.039) of induction. The mean blood pressure values were lower in the DEX group in the 5th (p < 0.001), 45th (p = 0.003), and 60th (p = 0.05) minutes of induction. The VAS score was lower in the DEX group in the 30th postoperative minute (p = 0.001); however, the VAS score was lower in the control group after the 12th hour (p < 0.001). Postoperative side effects such as nausea, tachycardia, hypotension, and vomiting were significantly less frequent in the DEX group (p < 0.001).


CONCLUSIONS
We observed that the intraoperative bleeding, hemodynamic stability, and VAS scores were better and the side effects were less frequent in the DEX group.
Department of Otorhinolaryngology, Duzce University School of Medicine, Duzce, Turkey.
Damla Guclu
DG
Guven
Yavuz
Y
Demiraran
Gulbin
G
Sezen
Okkes
O
Kepek
Abdulkadir
A
Iskender
D000293:Adolescent; D058647:Adrenergic alpha-2 Receptor Agonists / Q000009:adverse effects / Q000627:therapeutic use*; D000328:Adult; D016063:Blood Loss, Surgical / Q000517:prevention & control; D002908:Chronic Disease; D016292:Procedural Sedation; D020927:Dexmedetomidine / Q000009:adverse effects / Q000627:therapeutic use*; D004724:Endoscopy; D005260:Female; D006339:Heart Rate / Q000187:drug effects; D006439:Hemodynamics / Q000187:drug effects; D006801:Humans; D008297:Male; D008875:Middle Aged; D010256:Paranasal Sinuses / Q000601:surgery*; D011446:Prospective Studies; D012852:Sinusitis / Q000601:surgery; D016896:Treatment Outcome
D058647:Adrenergic alpha-2 Receptor Agonists; D020927:Dexmedetomidine