Dexmedetomidine combined with esmolol controls hypotension in patients undergoing endoscopic surgery

Objective: This study aimed to explore the effect of dexmedetomidine combined with esmolol on hemorrhaging and hemodynamics in patients undergoing endoscopic surgery. Methods: In total, 160 patients with chronic sinusitis (CRS) who underwent elective endoscopic surgery under general anesthesia were randomly and equally divided into the study group (SG) and control group (CG). The CG was given 1 mu g/kg dexmedetomidine intravenously (time > 10 min) and sustained infusion at 0.4-0.8 mu g/(kg/h) for concentration maintenance. On the basis of treatment with dexmedetomidine given to the CG, the SG was also given 1 mg/kg of esmolol in 1 minute, followed by continuous infusion of 0.4-0.8 mg/(kg/h) for concentration maintenance. The following parameters were recorded, including extubation, MAP and heart rate (HR) at the time of before (T0) and 5 min (T1) after anesthesia, 20 min (T2) and 40 min (T3) after hypotension, at the end of surgery (T4) and 10 min (T5) after extubation; intraoperative field quality score, operative blood loss and tracheal extubation time. The visibility of the surgical field was evaluated by the Fromme method. Ramsay sedation Score was used to evaluate postoperative sedation effect, and Visual Analogue Score (VAS) was used to Score postoperative pain. Results: After receiving controlled hypotension (T2, T3), HR and MAP decreased in both groups (P<0.05). After the end of controlled hypotension (T4, T5), HR increased in both groups (P<0.05), but the HR and MAP of the SG were lower than those of the CG at T4 and T5 (P<0.05). The bleeding volume, Fromme score and VAS score of the SG were lower than those of the CG (P<0.05). The Ramsay score of the SG was higher than that of the CG (P<0.05). The incidence of total adverse reactions in the CG was higher than that in the SG (P<0.05). Conclusion: In nasal endoscopic surgery, both dexmedetomidine alone and dexmedetomidine combined with esmolol can effectively control hypotension, but the latter has the advantages of better quality, less pain, and less adverse reactions.