Dexmedetomidine inducing controlled hypotension in functional endoscopic sinus surgery

Abstract

Objective To investigate the security and efficacy of dexmedetomidine inducing controlled hypotension m functional endoscopic sinus surgery.Methods Sixty patients subjected to general anesthesia were divided into 2 groups:the sodiumnitroprusside group(group N) the dexmedetomidine group(group D).The MAP was retained at 60 mm Hg-70 mm Hg(1 mm Hg=0.133 kPa) by sodiumnitroprusside or dexmedetomidine.Recorded the HR,MAP were recorded before operation(T0),during operation(T1) and the time of extubation(T2).The time from the begining of opration to the target hypotension,duration of operation and hypotension,extubation time,amount of bleeding and urine volum were recorded.Quality of the surgical field,the consciousness of patients and complications were assessed.Results There was no significant difference in age,weight,sex,duration of operation and controlled hypotension in the two groups.The MAP was retained at 60 mm Hg-70 mm Hg in all patients.There was no significant difference in MAP,HR in the two groups at the T0.The time from the begining of operation to the target hypotension was slower in the group D[(16.7±3.7) min]than in the group N[(10.1±1.8) min](P＜0.05).The HR was significantly increased at T1 and T2 in the group N[ ( 105±7 )、( 82±5 ) bpm ],but slower in tje group D[ (74±7) 、(69±8) bpm ](P＜0.05).Rebound hypertension occurred in the group N when extubating.The group D extubation MAP[(84+10) mm Hg] was still lower than the level of preinducfion [(95±8) mm Hg].The quality of the surgical field was better in the group D scores of surgical field quality(SSFQ) [ (1.2±0.4) points] than in the group N [(1.9±0.5) points] while the extubation time was shoaer in the group N [(14.5±1.8) min] than in the group D [ (16.5±2.7) min ] (P＜0.05).The consciousness of patients was better in the group D [ (2.0±0.3) points ] than inthe group N[(1.5±0.5) points].Six patients felt frustrated after operation in the group N.Amount of bleeding volume is fewer in the group D [(111±45) ml] than in the group N [(191±43) ml](P＜0.05).Amount of urine volume is fewer in the group N [(230±83) ml] than in the group D [ (390±105) ml] (P＜0.05).There were no postoperative complications in all patients.Conclusions Induced hypotension by dexmedetomidine is feasible and safe in the functional endoscopic sinus surgery.It shows good quality of the surgical field and fewer adverse reactions. Key words: Dexmedetomidine; Controlled hypotension; Endoscopic sinus surgery; General anesthesia; Sodium nitroprusside