Comparison between Dexmedetomidine and Remifentanil for Controlled Hypotension and Recovery in Endoscopic Sinus Surgery

Abstract

Although remifentanil and dexmedetomidine both enabled hypotensive anesthesia and good intraoperative fields for endoscopic sinus surgery, recovery was faster with remifentanil than with dexmedetomidine in the immediate postoperative period.

Comparison of Dexmedetomidine-Isoflurane versus Fentanyl-Propofol based anesthesia for controlled hypotension in functional endoscopic sinus surgery

“…Dexmedetomidine augments hypotensive action and reduce intraoperative bleeding. Various studies show that dexmedetomidine can be used for induced hypotension in endoscopic surgeries under general anaesthesia 1,8,9 .…”

Target‑controlled infusion of propofol and remifentanil combined with dexmedetomidine reduces functional endoscopic sinus surgery bleeding

“…Surgical bleeding is a critical issue in FESS since bleeding makes the anatomical structure difficult to identify, leading to serious complications and affecting the outcomes of surgery (5). Numerous studies have indicated controlled hypotension with anesthetic or vasoactive drugs may reduce bleeding and improve the quality of FESS (11,(14)(15)(16). However, vasoactive drugs cannot reduce the FESS bleeding when MAP was controlled at level of 65-75 mmHg (17); conversely, vascular dilation caused by the drug would increase surgical bleeding and has a negative impact on the surgical field (14).…”

“…The control group were administered with an intravenous pump injection normal saline equivalent to the volume of dexmedetomidine administered in the experimental group. All patients entered the operating room without pre-medication and having fasted for [8][9][10][11][12] h. An anesthesia monitor was used (Compact Anesthesia Monitor; GE Healthcare, Chicago, IL, USA) and routine electrocardiogram monitoring was carried out. Saturation of peripheral oxygen (SpO 2 ) and end tidal carbon dioxide (PetCO 2 ) were monitored.…”

“…Dexmedetomidine is a highly selective α2 adrenoceptor agonist which inhibits activity of the sympathetic nervous system, reduces the release of catecholamines, lowers blood pressure and slows the HR (9 that dexmedetomidine, like remifentanil, is effective in controlling blood pressure and maintaining hemodynamic stability, so as to achieve the same surgical field as remifentanil (10,11). However, it is not yet known what the effects would be if these two drugs were used in combination.…”

Controlled Hypotensive Anesthesia in Children Undergoing Nasal Surgery

“…Dexmedetomidine was found to be a useful and effective adjuvant to minimize bleeding and induce dry surgical field in both ear and nasal surgery [23][24][25][26][27][28].…”