INTRODUCTION: Bleeding resulting in impaired intraoperative visibility and increased risk of injury to vital structures such as optic nerve and internal carotid artery requires effective control in form of controlled hypotension during functional endoscopic sinus surgeries. Our aim in this study is to assess the effectiveness of dexmedetomidine in reducing blood loss during functional endoscopic sinus surgeries (FESS) when used for controlled hypotension.
METHODS: Ninety-two American Society of Anaesthesiologists – ASA class I and II patients of comparable demographic profile, scheduled for elective FESS received either Inj. dexmedetomidine 1 mcg/kg/hr for initial 10 minutes and then 0.5 mcg/kg/min as infusion or equal volume of saline infusion. The hemodynamic changes, intraoperative rescue medication consumption, intraoperative blood loss, emergence time, postoperative sedation and pain score were recorded.
RESULTS: Patients in the dexmedetomidine group had a remarkable reduction in blood loss (p-value – 0.000) with lesser intraoperative mean arterial blood pressure, heart rate, better sedation and pain scores postoperatively. The mean intraoperative rescue medication consumption was remarkably higher in patients of group B. Extubation time in group A patients was significantly higher (9.04 minutes) than in group B patients (5.07 minutes) (p-value-0.000).
DISCUSSION AND CONCLUSION: Dexmedetomidine is an optimal effective agent that reduces blood loss by controlled hypotension during FESS providing ideal surgical field with better sedative and analgesic properties.