title: Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review.
abstract: BACKGROUND
  Intra-operative bleeding diminishes visualisation during functional endoscopic sinus surgery and can cause unfavourable outcomes. Dexmedetomidine is a potent alpha-2 agonist, with sympatholytic effects. This systematic review aimed to assess whether dexmedetomidine decreases intra-operative bleeding and improves operative field quality.
  
  
  METHODS
  All randomised, controlled trials that assessed the ability of dexmedetomidine to provide good operative fields for functional endoscopic sinus surgery were identified from Medline and Embase. The outcomes of interest were: operative field quality, intra-operative bleeding, operative time and adverse events.
  
  
  RESULTS
  Five studies (254 patients) met the inclusion criteria. When compared to saline, dexmedetomidine improved the quality of the operative field. The operative time was similar between groups. When compared to other drugs, dexmedetomidine was as effective as esmolol and remifentanil. There were no adverse incidents.
  
  
  CONCLUSIONS
  Dexmedetomidine is beneficial in providing good visibility during functional endoscopic sinus surgery. Controlled hypotensive anaesthesia with this medicine decreases intra-operative bleeding and enhances surgical field quality.
authors.affiliation: Department of Otolaryngology,Faculty of Medicine,Chulalongkorn University,Bangkok.
authors.forename: K
authors.initials: K
authors.lastname: Snidvongs
authors.affiliation: Department of Anesthesiology,King Chulalongkorn Memorial Hospital,Bangkok,Thailand.
authors.forename: W
authors.initials: W
authors.lastname: Tingthanathikul
authors.affiliation: Department of Otolaryngology,Faculty of Medicine,Chulalongkorn University,Bangkok.
authors.forename: S
authors.initials: S
authors.lastname: Aeumjaturapat
authors.affiliation: Department of Otolaryngology,Faculty of Medicine,Chulalongkorn University,Bangkok.
authors.forename: S
authors.initials: S
authors.lastname: Chusakul
mesh_terms: D018712:Analgesics, Non-Narcotic / Q000008:administration & dosage*; D016063:Blood Loss, Surgical / Q000517:prevention & control; D020927:Dexmedetomidine / Q000008:administration & dosage*; D006801:Humans; D059747:Nasal Surgical Procedures / Q000009:adverse effects / Q000379:methods*; D057605:Natural Orifice Endoscopic Surgery / Q000009:adverse effects / Q000379:methods*; D010256:Paranasal Sinuses / Q000601:surgery*; D016032:Randomized Controlled Trials as Topic
chemical_list: D018712:Analgesics, Non-Narcotic; D020927:Dexmedetomidine
keywords: Dexmedetomidine; Paranasal Sinuses; Sinus Surgery