Comparison of dexmedetomidine versus propofol-based anaesthesia for controlled hypotension in functional endoscopic sinus surgery

Keywords: controlled hypertension, dexmedetomidine, FESS, propofol, surgical field

Abstract

Background: Increased intraoperative bleeding during functional endoscopic sinus surgery (FESS) affects operative field visibility, which increases both duration of surgery and frequency of complications. Controlled hypotension is an anaesthetic technique in which there is deliberate reduction of systemic blood pressure during anaesthesia. The aim of the study was to compare the efficacy of dexmedetomidine against propofol infusion when used for controlled hypotension during FESS.

Methods: A randomised, prospective, and single-blinded study was carried out, which included 80 patients of either sex of ASA grade І & ІІ who underwent elective FESS. Patients were randomly assigned to two groups: Group A (dexmedetomidine), Group B (propofol). Intraoperative mean arterial pressure (MAP), heart rate (HR), surgical grade of bleeding (based on the Fromme– Boezzart scale), and amount of bleeding were recorded.

Results: Groups were well matched for their demographic data. There was a statistically significant difference (p < 0.05) between Group A and Group B in heart rate, mean arterial pressure (MAP) and mean total blood loss, with Group A being effectively in controlled on all three parameters during FESS. However, there was no significant difference (p > 0.05) in terms of surgical grade of bleeding between Group A and Group B.

Conclusions: Both dexmedetomidine and propofol infusion are efficacious to facilitate controlled hypotension and haemodynamic stability intraoperatively.

Author Biographies

D K Bharathwaj, Kasturba Medical College

Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

Shaila Surendra Kamath, Kasturba Medical College

Department of Anaesthesiology, Kasturba Medical College, Mangalore, Manipal Academy of Higher Education, Manipal, Karnataka, India

Published
2019-03-12
Section
Research Articles