Induced hypotension in ambulatory functional endoscopic sinus surgery: A comparison between dexmedetomidine and clonidine as premedication. A prospective, double-blind, and randomized study

被引:10
作者
Das, A. [1 ,2 ]
Mukherje, A. [3 ]
Chhaule, S. [1 ,2 ]
Chattopadhyay, S. [1 ,2 ]
Halder, P. S. [1 ,2 ]
Mitra, T. [4 ]
Basunia, S. R. [5 ]
Mandal, S. K. [1 ,2 ]
机构
[1] Coll Med, Dept Anaesthesiol, Kolkata, W Bengal, India
[2] Sagore Dutta Hosp, Kolkata, W Bengal, India
[3] NRS Med Coll, Dept Anaesthesiol, Kolkata, W Bengal, India
[4] Murshidabad Med Coll, Dept Anaesthesiol, Berhampur, W Bengal, India
[5] Midnapore Med Coll & Hosp, Dept Anaesthesiol, Midnapore, W Bengal, India
关键词
Ambulatory (day care); clonidine; dexmedetomidine; functional endoscopic sinus surgery; mean arterial pressure;
D O I
10.4103/1658-354X.169480
中图分类号
R614 [麻醉学];
学科分类号
100217 ;
摘要
Background: Functional endoscopic sinus surgery (FESS) is the mainstay of a therapeutic technique for nasal pathologies. This study is to compare the ability of preoperative dexmedetomidine versus clonidine for producing controlled hypotensive anesthesia during FESS in adults in an ambulatory care setting. Materials and Methods: Sixty patients (25-50 years) posted for ambulatory FESS procedures under general anesthesia were randomly divided into Group C and D (n = 33 each) receiving dexmedetomidine 1 mg/kg and clonidine 1.5 mg/kg, respectively; both diluted in 100 ml saline solution 15 min before anesthetic induction. Nasal bleeding and surgeons satisfaction score; amount and number of patients receiving fentanyl and nitroglycerine for analgesia and deliberate hypotension, duration of hypotension, post anesthesia care unit (PACU) and hospital stay; hemodynamic parameters and side effects were recorded for each patient. Results: Number and dosage of nitroglycerine used was significantly (P = 0.034 and 0.0001 respectively) lower in Group D compared to that in Group C. Similarly, number of patients requiring fentanyl and dosage of same was significantly lower in Group D. But, the duration of controlled hypotension was almost similar in both the groups. Group D patients suffered from significantly less nasal bleeding and surgeons satisfaction score was also high in this group. Discharge from PACU was significantly earlier in Group D, but hospital discharge timing was quite comparable among two groups. Intraoperative hemodynamics was significantly lower in Group D (P < 0.05) without any appreciable side effects. Conclusion: Dexmedetomidine found to be providing more effectively controlled hypotension and analgesia, and thus, allowing less nasal bleeding as well as more surgeons satisfaction score.
引用
收藏
页码:74 / 80
页数:7
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