Comparison of dexmedetomidine and propofol infusion on intraoperative haemodynamics during functional endoscopic sinus surgery under general anaesthesia- A randomized controlled trial

Abstract

Functional endoscopic sinus surgery (FESS) is a surgical technique to treat sinonasal diseases. Intraoperative bleeding is one of the major challenges, which hinder the confined area of visibility and prolongs the procedure. Intraoperative induced hypotension can reduce intraoperative bleeding, to provide clear surgical field for dissection and hence decreasing operative time. So, we compared effect of dexmedetomidine and propofol infusion on the intraoperative haemodynamics during functional endoscopic sinus surgery (FESS). To study the effect of intravenous (IV) dexmedetomidine and propofol infusion on intraoperative haemodynamics under general anaesthesia in functional endoscopic sinus surgery(FESS). Secondary aim was to study estimated blood loss if any. To study the effect of I.V. dexmedetomidine and propofol infusion on intraoperative haemodynamics under general anaesthesia in functional endoscopic sinus surgery (FESS). Patients were divided randomly by sealed envelope method into two groups with 30 patients in each group. Group D patients received dexmedetomidine 1ug/kg as a loading dose over 20 minutes followed by 0.3 ug/kg/hr infusion for maintainence. Group P patients received propofol 2mg/kg as a loading dose followed by 100-200 ug/kg/min infusion for maintenance. The findings in our study highlights that dexmedetomidine infusion decreases haemodynamic parameters like arterial blood pressure and heart rate more as compared to propofol infusion during FESS. The effect on hemodynamics sustained and consistent without requirement of additional hypotensive agents. So altogether, this lead to better surgical field. Use of dexmedetomidine is a safe and effective method to control bleeding and improve the quality of surgical field and intraoperative haemodynamics.