A Comparision of Nitroglycerine and Dexmedetomidine for Controlled Hypotension in Endoscopic Resection of Juvenile Nasopharyngeal Angiofibroma

Abstract

Background: Juvenile nasopharyngeal angiofibroma(JNA) is a locally invasive benign vascular tumor, controlled hypotension is used to facilitate endoscopic resection. Nitroglycerine and Dexmedetomidine were compared as hypotensive agents in this study. Methods : Ethics Committee has approved the study which was conducted at Government ENT hospital, Hyderabad during 2016 – 2018.Study included 40 patients divided into two groups, Group D (Dexmedetomidine) n=20,1µg/kg over 15 min followed by a maintenance infusion at 0.5µg/kg/hr,GroupN(Nitroglycerine) n=20- Nitroglycerine @ 0.5µg/kg/min and titrated in doses 0.5-5µg/kg/min for target blood pressure respectively. Results : A statistically significant difference was observed in the study in mean pulse rate between two groups Group D-66.09±2.83, Group N-86.59±4.24, p value 0.0001. Blood loss was lower in Group D-310.71±140.58 compared to Group N 482.61±141.42 , and is statistically significant (p value 0.0004). SBP, DBPand MAP were comparatively lower in Group D throughout the surgery. Conclusions: Dexmedetomidine is a better hypotensive agent with favourablehemodynamics and significantly less blood loss when compared to Nitroglycerine.