Comparative evaluation of propofol versus dexmedetomidine infusion for hypotensive anesthesia during functional endoscopic sinus surgery: a prospective randomized trial.

Content Provider	Europe PMC
Author	Gupta, Kewal Krishan Kumari, Vandana Kaur, Sarvjeet Singh, Amanjot
Copyright Year	2022
Abstract	BackgroundDuring functional endoscopic sinus surgery (FESS), intranasal bleeding affects operative field visibility and increases the frequency of complications. Therefore, hypotensive anesthesia is a widely used technique to improve surgical outcomes. This study aimed to compare the efficacy of propofol and dexmedetomidine infusion for hypotensive anesthesia in patients undergoing FESS.MethodsThis prospective randomized trial was conducted in 80 adult patients who were scheduled for FESS under general anesthesia. Patients were randomly divided into two groups: group P (n = 40) received propofol infusion of 100–200 µg/kg/min and group D (n = 40) received dexmedetomidine infusion with a loading dose of 1 µg/kg over 10 min after induction, followed by maintenance infusion of 0.4–0.8 µg/kg/h. Intraoperative blood loss, quality of the surgical field (Fromme– Boezaart scale), hemodynamic control, and patient recovery were recorded. Statistical analysis was performed using Student’s t-test, chi-square test, and Mann– Whitney U test.ResultsThe mean arterial pressure and heart rate were significantly lower in group D throughout the surgery than in group P. Blood loss was significantly higher in group P (100.73 ± 18.12 ml) than in group D (85.70 ± 18.56 ml). The average number of patients with Fromme’s score 1/2/3 was comparable between the groups. Intraoperatively, only one incidence of bradycardia and hypotension was observed in group D (2.5%) compared to group P.ConclusionsBoth dexmedetomidine and propofol are efficacious and safe drugs for facilitating controlled hypotension during FESS; however, dexmedetomidine provides better hemodynamic control and is associated with lesser blood loss without any significant adverse effects.
Related Links	https://europepmc.org/backend/ptpmcrender.fcgi?accid=PMC9346206&blobtype=pdf
ISSN	19755171
Journal	Anesthesia and Pain Medicine [Anesth Pain Med (Seoul)]
Volume Number	17
DOI	10.17085/apm.21118
PubMed Central reference number	PMC9346206
Issue Number	3
PubMed reference number	35918859
e-ISSN	23837977
Language	English
Publisher	Korean Society of Anesthesiologists
Publisher Date	2022-06-14
Access Restriction	Open
Rights License	This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. Copyright © the Korean Society of Anesthesiologists, 2022
Subject Keyword	Dexmedetomidine Induced hypotension Functional endoscopic sinus surgery Propofol
Content Type	Text
Resource Type	Article
Subject	Anesthesiology and Pain Medicine