Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review

Abstract

Dexmedetomidine is beneficial in providing good visibility during functional endoscopic sinus surgery. Controlled hypotensive anaesthesia with this medicine decreases intra-operative bleeding and enhances surgical field quality.

Effectiveness of Dexmedetomidine for Controlled Hypotension in Providing Optimum Surgical Conditions for Functional Endoscopic Sinus Surgeries: A Double-Blinded Randomized Controlled Trial

“…In their review, Snidvongs K et al (15) found that the quality of operative field for FESS was greatly improved when dexmedetomidine was used as an adjuvant which is consistent with our study findings. Similarly, in their study Gupta K et al (16) also substantiated that dexmedetomidine provides an ideal oligemic surgical field for FESS similar to the findings of our study.…”

Efficacy of dexmedetomidine on perioperative morbidity during nasal surgery: A meta‐analysis

“…To control bleeding, stable and lower hemodynamics are necessary to achieve less blood loss in the surgical field. A previous review demonstrated that hemodynamic control with dexmedetomidine decreased intraoperative bleeding and enhanced surgical field quality . This study also showed that operative blood loss was significantly lower in the dexmedetomidine group than in the control group, which could be explained by the fact that dexmedetomidine is a potent alpha‐2 adrenoceptor agonist with an action that inhibits noradrenaline release.…”

“…Additionally, central nervous system stimulation of postsynaptic alpha‐2 receptors leads to the inhibition of sympathetic activity, which decreases noradrenaline release, blood pressure, and heart rate. The hypotensive actions and hemodynamic stability reduce intraoperative bleeding . These characteristics of dexmedetomidine make it a potentially useful drug during MAC.…”

“…Due to the anatomical characteristics of the nasal cavity, such as its narrowness and hypervascularity, good intraoperative hemorrhage control is highly recommended . In particular, it is essential to minimize bleeding in endoscopic sinus surgery to achieve clear endoscopic vision . To control bleeding, stable and lower hemodynamics are necessary to achieve less blood loss in the surgical field.…”

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

“…The reason for this is that inhalation anesthetics dilate blood vessels and cause reflex tachycardia (23). Although inhalation anesthetics can reduce MAP, the surgical approach was still not improved because of the increased HR and dilated nasal mucosal vessels during FESS (24). Even if balanced anesthesia combined with esmolol controls the HR, the surgical approach is not ameliorated compared with total intravenous anesthesia (25).…”