Dexmedetomidine supplementation for surgical field enhancement in endonasal surgery: a systematic review and meta-analysis.

Abstract

Dexmedetomidine has been shown to effectively control intraoperative bleeding and improve surgical field visualization. However, its value in endonasal surgeries remains a matter of debate. We searched PubMed, Embase, and Cochrane Central Register of Controlled Trials for studies comparing dexmedetomidine with placebo in endonasal surgeries. Outcomes included bleeding, operative time (OT), surgeon’s satisfaction, postoperative pain (POP), and nausea/vomiting (PONV). For statistical analysis, we used RevMan 5.4.1, and assessed heterogeneity with I2 statistics. We included a total of 1386 patients from 22 studies. In the placebo group, there was higher bleeding volume, whereas the dexmedetomidine group showed lower scores on the Fromme-Boezaart scale. Additionally, the surgeon satisfaction risk ratio (RR) increased, and OT was reduced in the dexmedetomidine group. The dexmedetomidine group had lower incidences of POP and PONV. In endonasal surgeries, dexmedetomidine was associated with improvements in surgical field visualization as evidenced by reduced intraoperative bleeding and postoperative morbidities.