The effects of dexmedetomidine on airway-related complications during emergence from general anesthesia in nasal and paranasal surgeries

Background: Stimulation of various sites, from the nasal mucosa to the diaphragm, can evoke laryngospasm. To reduce airway reflexes, tracheal extubation should be performed by special technique or with drugs that do not depress ventilation. However, tracheal extubation during rhinoplasty may be difficult because of the aspiration of blood and the possibility of laryngospasm. Dexmedetomidine has sedative and analgesic effects, without affecting respiratory status. Objectives: To evaluate the effects of dexmedetomidine on airway-related complications during emergence from general anesthesia (GA) in nasal and paranasal surgeries. Patients and Methods: This prospective randomized clinical study was included 90 patients of both sexes, admitted for elective nasal and paranasal sinus surgery. They were randomly allocated into three groups 30 patients each, Group A: Standard awake extubation technique. Group B: fully awake "no stimulation extubation" technique. Group C: Dexmedetomidine­group, who received intravenous (I.V) dexmedetomidine 0.5-1 µg/kg bolus in 100 ml of normal saline over 10 minutes before the end of surgery by 10 minutes, The dexmedetomidine bolus was followed by 0.2 µg/kg/hr which was stopped immediately when extubation was done. Results: The following parameters were assessed between the three groups: hemodynamics, airway-related complications, extubation time. Group C: was associated with a significant increase in extubation quality compared with group A and group B regarding hemodynamics, airway-related complications, extubation time. Conclusion: This study showed that the dexmedetomidine group associated with minimal circulatory reflexes and airway-related complications further to the advantage of short extubation time compared with the "no stimulation" extubation technique

Indications et resultats de la septoplastie chez l'enfant

La septoplastie chez l'enfant est un sujet de controverse jusqu'a nos jours. Notre etude est retrospective a propos de 47 cas colliges au service ORL de l'hopital Tahar Sfar de Mahdia sur une periode de 19 ans (1988-2006). L'age moyen de nos malades est de 13;8 ans. Le sexe masculin est predominant (63;8). Tous nos malades ont beneficie d'un examen rhinologique et un bilan radiologique standard. A cote de la deviation de la cloison nasale nous avons note une deviation de la pyramide nasale chez 4 malades. Tous nos malades ont beneficie d'une septoplastie sous anesthesie generale. Apres un recul moyen de 2 ans nous avons un bon resultat fonctionnel (fosses nasales permeables) chez 37 malades