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KMID : 1155520220170030271
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Anesthesia and Pain Medicine
2022 Volume.17 No. 3 p.271 ~ p.279
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Comparative evaluation of propofol versus dexmedetomidine infusion for hypotensive anesthesia during functional endoscopic sinus surgery: a prospective randomized trial
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Gupta Kewal Krishan
Kumari Vandana
Kaur Sarvjeet
Singh Amanjot
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Abstract
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Background: During 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.
Methods: This 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.
Results: The 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.
Conclusions: Both 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.
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KEYWORD
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Dexmedetomidine, Induced hypotension, Functional endoscopic sinus surgery, Propofol
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