EC Paediatrics

Background: Functional endoscopic sinus surgery (FESS) is one of the most common surgeries in the field of otolaryngology. Intraoperative bleeding is the most common factor impairing visibility, leading to an increased incidence of complications.

Purpose of the Study: To study the efficacy of dexmedetomidine in preventing bleeding in functional endoscopic sinus surgery (FESS).

Materials and Methods of Research: The study was conducted at the surgical clinic of the Azerbaijan Medical University. The study included 50 patients aged 15 - 65 years who underwent planned functional endoscopic sinus surgery (FESS). Depending on the method of anesthesia used, patients were divided into two groups. In the main group, dexmedetomidine was added to the general anesthesia regimen.

Research Results: It was found that the mean arterial pressure in the main group (with dexmedetomidine) both at the stage of surgical intervention and after awakening was significantly lower than in the control group (p < 0.05). The heart rate was also lower in the main group than in the control group (p < 0.05), both at the stage of surgery 68.6 ± 2.20 and 78.9 ± 1.22, and after the end of the surgery 74.6 ± 1.26 and 82.3 ± 1.52, respectively (p < 0.05).

Conclusion: Dexmedetomidine infusion during FESS procedures significantly reduced the volume of bleeding, decreased the need for anesthetics and opioids, improved visualization of the surgical field and significantly reduced the duration of the operation.

 Keywords: Dexmedetomidine; Functional Endoscopic Sinus Surgery

1. Kaygusuz K., et al. “Hypotensive anaesthesia with remifentanil combined with desflurane or isoflurane in tympanoplasty or endoscopic sinus surgery: a randomised, controlled trial”. Journal of Laryngology and Otology 7 (2008): 691-695.
2. Das A., et al. “Induced hypotension in ambulatory functional endoscopic sinus surgery: A comparison between dexmedetomidine and clonidine as premedication. A prospective, double-blind, and randomized study”. Saudi Journal of Anaesthesia 1 (2016): 74-80.
3. Das A., et al. “Controlled hypotension in day care functional endoscopic sinus surgery: A comparison between esmolol and dexmedetomidine: A prospective, double-blind, and randomized study”. Saudi Journal of Anaesthesia 3 (2016): 276-282.
4. Karabayirli S., et al. “Surgical conditions during FESS comparison of dexmedetomidine and remifentanil”. European Archives of Oto-Rhino-Laryngology1 (2016): 239-245.
5. Bayram A., et al. “Comparison between magnesium and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery”. Revista Brasileira de Anestesiologia 1 (2015): 61-67.
6. Bajwa S., et al. “Nitroglycerine, esmolol and dexmedetomidine for induced hypotension during functional endoscopic sinus surgery: A sulfate comparative evaluation”. Journal of Anaesthesiology Clinical Pharmacology 2 (2016): 192-197.
7. Cardesin A., et al. “Hypotensive anaesthesia and bleeding during endoscopic sinus surgery: an observational study”. European Archives of Oto-Rhino-Laryngology 6 (2014): 1505-1511.
8. Guven DG., et al. “Evaluation of outcomes in patients given dexmedetomidine in functional endoscopic sinus surgery”. Annals of Otology, Rhinology and Laryngology 9 (2011): 586-592.
9. Ayoglu H., et al. “Effectiveness of dexmedetomidine in reducing bleeding during septoplasty and tympanoplasty operations”. Journal of Clinical Anesthesia 6 (2008): 437-441.
10. Liu T., et al. “Effects of a single dose dexmedetomidine on surgical field visibility during middle ear microsurgery: a randomized study”. Otology and Neurotology 6 (2016): 680-684.