Comparing the hemodynamic changes, bleeding, and surgeon’s satisfaction during rhinoplasty surgery by use of two drugs, labetalol and dexmedetomidine added to anesthetic technique: a randomized clinical trial

Abstract

Background: Rhinoplasty is a common surgery in the world. Bleeding is a common concern during rhinoplasty. Hemodynamic stability and quality of view of the surgical field help to achieve the best results. The aim was to compare the effect of two drugs, dexmedetomidine and labetalol, on the amount of bleeding and satisfaction with rhinoplasty surgery. Methods: A cross-sectional descriptive study includes candidates for rhinoplasty surgery, referring to Moradi Hospital in Rafsanjan. Twenty patients were assigned to each group (dexmedetomidine and labetalol) based on the entry and exit criteria. Systolic and diastolic blood pressures and mean arterial pressure were measured before, 20 minutes after complete anesthesia, and the start of rhinoplasty surgery. All patients were operated by the same surgeon using the same technique. The surgeon’s level of satisfaction indicated with the field of vision is given as follows: good, moderate, and poor. Results: The study was performed on 40 subjects in two groups (n = 20), of which 14 (35 %) were male and 26 (65 %) were female. The results presented statistically significant differences in mean osteotomy systolic blood pressure (P = 0.018), osteotomy diastolic blood pressure (P = 0.015), mean osteotomy arterial pressure (P = 0.002), after 20 minutes heart rate (P < 0.001), and osteotomy heart rate (P = 0.001) between two groups. Furthermore, significant differences were observed regarding systolic blood pressure (P = 0.015), mean arterial pressure (P = 0.03), and heart rate (P < 0.001) after controlling for the effect of the group. Conclusions: The labetalol is the preferred option for controlling hypotension that provides better surgical field visibility compared to dexmedetomidine in rhinoplasty surgery.