title: Intranasal atomised dexmedetomidine optimises surgical field visualisation with decreased blood loss during endoscopic sinus surgery: a randomized study.
abstract: Safe and effective endoscopic sinus surgery (ESS) depends on distinct surgical visibility. Various interventions are proposed to reduce intranasal bleeding. This study investigated whether intranasal atomised dexmedetomidine (DEX) provided optimal surgical conditions and decreased blood loss.
  
  
  
  ASA I or II patients undergoing ESS were randomly assigned to receive either 2 μg/kg intranasal DEX (group D) or the same volume of saline (group N) 15 min before induction. Lund-Mackay (LM) scores represented the extent of the preoperative surgical lesion and were obtained based on the computed tomographic scans. Estimated blood loss was recorded. The visibility of the surgical field was rated by surgeons on a numerical rating scale (NRS) or assessed using Boezaart score.
  
  
  
  Median blood loss in groups D and N was 75 and 100 ml, respectively. NRS and Boezaart score for surgical condition were lower in group D than in group N. LM score showed a positive correlation between NRS and Boezaart score in group N but not in group D.
  
  
  
  Intranasal atomised DEX resulted in improved surgical conditions with less bleeding during ESS despite the severity of the preoperative surgical lesion.
authors.affiliation: Department of Anesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
authors.forename: H
authors.initials: H
authors.lastname: Qiao
authors.affiliation: Department of Anesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
authors.forename: J
authors.initials: J
authors.lastname: Chen
authors.affiliation: Department of Anesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
authors.forename: W
authors.initials: W
authors.lastname: Li
authors.affiliation: Department of Anesthesiology, The Eye Ear Nose and Throat Hospital, Fudan University, Shanghai, China.
authors.forename: X
authors.initials: X
authors.lastname: Shen
mesh_terms: D000281:Administration, Intranasal; D058647:Adrenergic alpha-2 Receptor Agonists / Q000008:administration & dosage*; D000328:Adult; D058126:Balanced Anesthesia; D016063:Blood Loss, Surgical / Q000517:prevention & control*; D020927:Dexmedetomidine / Q000008:administration & dosage*; D004311:Double-Blind Method; D005260:Female; D006801:Humans; D007430:Intraoperative Care; D008297:Male; D008875:Middle Aged; D057605:Natural Orifice Endoscopic Surgery; D012852:Sinusitis / Q000601:surgery*
chemical_list: D058647:Adrenergic alpha-2 Receptor Agonists; D020927:Dexmedetomidine