Dexmedetomidine and esmolol for induced hypotension for functional endoscopic sinus surgery-a comparative study

ABSTRACT

Background: Functional endoscopic sinus surgery is a minimally invasive surgical procedure performed under controlled hypotensive anesthesia. This technique has the advantage of minimal blood loss and visualizes surgical field distinctly. Aim and Objectives: To compare the efficacy of Dexmedetomidine and Esmolol for the induction of controlled hypotension in functional endoscopic sinus surgeries. Materials and Methods: A total of 80 cases with paranasal sinus pathologies posted for functional endoscopic sinus surgeries between 21 and 60 years were recruited. Study participants were randomly divided into two study groups, i.e. Group 1 administered with dexmedetomidine and Group 2 administered with Esmolol. Parameters such as hemodynamics, total intraoperative fentanyl consumption, duration of surgery, and total blood loss were noted. Results: The mean difference of systolic blood pressure, diastolic blood pressure and mean arterial pressure was not statistically significant (P > 0.05). The mean difference of heart rate between two study groups was statistically significant (P < 0.05). The mean duration surgery in Group 1 was 87.9 min and in Group 2 was 89.5 min. The estimated blood loss was 132.2 ml in Group 1 and 134.2 ml in Group 2. No desaturation was observed in the study participants during recovery and the postoperative period. Conclusion: Both dexmedetomidine and esmolol infusion are efficacious and are safe drugs for maintaining controlled hypotension and improve the quality of surgical field. Dexmedetomidine was associated with good postoperative sedation while esmolol associated with early recovery time. Surgeon satisfaction score was similar was similar in both groups.