Efficacy of dexmedetomidine as an anesthetic adjuvantfor functional endoscopic sinus surgery under generalanesthesia: a randomized–controlled study

BackgroundFunctional endoscopic sinus surgery (FESS) requires effective control of bleeding for better visibility of the operating field and reduced risk of injury to the optic nerve or the internal carotid artery. Dexmedetomidine can provide controlled hypotension, analgesia, and sedation. The present study aimed to evaluate the clinical efficacy, safety, and advantages of dexmedetomidine as an anesthetic adjuvant for FESS.Patients and methodsFifty adult consented patients of comparable demographic profile, scheduled for FESS, were assigned randomly to two groups. Patients of group D received a loading dose of dexmedetomidine 1 μg/kg over 10 min, followed by an infusion at 0.4–0.7 μg/kg/h and patients of group C were administered an identical amount of saline solution. During the procedure, hemodynamic changes, intraoperative surgical grade of bleeding (on the basis of the Fromme–Boezaart scale), intraoperative fentanyl consumption, emergence time, and total recovery from anesthesia (Aldrete’s score ≥9) were recorded.ResultsPatients of group D comparatively had a lower intraoperative heart rate and mean arterial blood pressure, along with a significantly lower bleeding score (P 0.001). The mean intraoperative fentanyl consumption was significantly lower in patients of group D. Emergence time and time to achieve an Aldrete’s score 9 or more were significantly lower in group C at 15 and 30 min postoperatively.ConclusionDexmedetomidine has effectively provided the ideal oligemic surgical field during FESS andoffers the inherent advantages of analgesia, sedation, and anesthetic-sparing effects.