Comparison of dexmedetomidine with nitroglycerinefor hypotensive anaesthesia in functional endoscopic sinus surgery

Abstract

Aim: The aim of the study is to compare Dexmedetomidine with Nitroglycerine for hypotensive anaesthesia for Functional Endoscopic Sinus Surgeries (FESS) with respect to quality of the surgical field, hemodynamics, amount of blood loss, intraoperative opioid requirement, time to first analgesic request and recovery profile. Methods: After approval by institutional Ethics Committee, 60 patients were randomly allocated by sealed envelope technique into two drug groups: Nitroglycerine (Group N) and Dexmedetomidine (Group D). After induction of anesthesia, Nitroglycerine infusion at 0.5-10 µg/kg/min was started for patients in group N and Dexmedetomidine was given as loading dose of 1 µg/kg over 10 min followed by maintenance infusion rate of 0.2- 0.7 µg/kg/hr for patients in group D. The infusion rates were then titrated to maintain MAP between 50-60 mm of Hg or 30% reduction of baseline MAP, whichever is higher. Parameters observed include heart rate, mean arterial pressure, blood loss (Average Category Scale), emergence time, time to first rescue analgesic and post-operative recovery (Modified Alderete Score). Results: In our study, statistically significant reduction in heart rate (58/min vs 69/min) was observed in patients in group D, while Systolic, diastolic and mean arterial pressure were comparable. The quality of surgical field as assessed by ACS was better in group D (p