Intranasal atomised dexmedetomidine optimises surgical field visualisation with decreased blood loss during endoscopic sinus surgery: a randomized study

Abstract

Background: Safe and effective endoscopic sinus surgery (ESS) depends on distinct surgical visibility. Various interventions are proposed to reduce intranasal bleeding. This study investigated whether intranasal atomised dexmedetomidine (DEX) provided optimal surgical conditions and decreased blood loss. Methods: ASA I or II patients undergoing ESS were randomly assigned to receive either 2 μg/kg intranasal DEX (group D) or the same volume of saline (group N) 15 min before induction. Lund-Mackay (LM) scores represented the extent of the preoperative surgical lesion and were obtained based on the computed tomographic scans. Estimated blood loss was recorded. The visibility of the surgical field was rated by surgeons on a numerical rating scale (NRS) or assessed using Boezaart score. Results: Median blood loss in groups D and N was 75 and 100 ml, respectively. NRS and Boezaart score for surgical condition were lower in group D than in group N. LM score showed a positive correlation between NRS and Boezaart score in group N but not in group D. Conclusion: Intranasal atomised DEX resulted in improved surgical conditions with less bleeding during ESS despite the severity of the preoperative surgical lesion.