title: Intranasal Dexmedetomidine on Stress Hormones, Inflammatory Markers, and Postoperative Analgesia after Functional Endoscopic Sinus Surgery.
abstract: BACKGROUND
  A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome. This study evaluated the effect of intranasally administered dexmedetomidine (DEX) in combination with local anesthesia (LA) on the relief of stress and the inflammatory response during functional endoscopic sinus surgery (FESS).
  
  
  METHODS
  Sixty patients undergoing FESS were randomly allocated to receive either intranasal DEX (DEX group) or intranasal saline (Placebo group) 1 h before surgery. Stress hormones, inflammatory markers, postoperative pain relief, hemodynamic variables, blood loss, surgical field quality, body movements, and satisfaction were assessed.
  
  
  RESULTS
  Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05). The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001). Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.
  
  
  CONCLUSIONS
  Patients receiving intranasal DEX with LA for FESS exhibited less perioperative stress and inflammatory response as well as better postoperative comfort with hemostatic stuffing and analgesia.
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Chaoliang
authors.initials: C
authors.lastname: Tang
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Xiang
authors.initials: X
authors.lastname: Huang
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Fang
authors.initials: F
authors.lastname: Kang
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Xiaoqing
authors.initials: X
authors.lastname: Chai
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Song
authors.initials: S
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Guobing
authors.initials: G
authors.lastname: Yin
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Hongtao
authors.initials: H
authors.lastname: Wang
authors.affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.
authors.forename: Juan
authors.initials: J
authors.lastname: Li
mesh_terms: D000328:Adult; D000698:Analgesia / Q000379:methods*; D001786:Blood Glucose / Q000187:drug effects; D020927:Dexmedetomidine / Q000627:therapeutic use*; D004311:Double-Blind Method; D004724:Endoscopy / Q000379:methods*; D004837:Epinephrine / Q000097:blood; D005260:Female; D006801:Humans; D007249:Inflammation / Q000097:blood / Q000188:drug therapy*; D015850:Interleukin-6 / Q000097:blood; D008297:Male; D008875:Middle Aged; D009638:Norepinephrine / Q000097:blood; D014409:Tumor Necrosis Factor-alpha / Q000097:blood
chemical_list: D001786:Blood Glucose; D015850:Interleukin-6; D014409:Tumor Necrosis Factor-alpha; D020927:Dexmedetomidine; D009638:Norepinephrine; D004837:Epinephrine