Research Paper

Effectiveness Of Dexmedetomidine To Reduce Bleeding During Tympanoplasty & Functional Endoscopic Sinus Surgery (fess) ; An Interventional Study

Abstract :

BACKGROUND AND OBJECTIVE: The aim of this study was to evaluate the efficacy of dexmedetomidine, an alpha(2)-adrenoceptor agonist, on intraoperative bleeding and duration of the surgery. This study shows the improvement of the efficacy of surgery with minimum bleeding, at the same time not compromising the hemodynamic stability of the patient.METHODS: sixty patients scheduled for elective tympanoplasty and FESS operations under general anaesthesia were included in the study. The patients were randomly assigned to receive either a dexmedetomidine 1 mcg/kg bolus 10mins before is given to Group (D) and a bolus dose of 10ml normal saline will be given to Group (P). After intubation in Group (D) maintenance dose of dexmedetomidine 0.5 to 0.8 mcg/kg/hr is started and the dose is titrated in between 0.5 to 0.8 mcg/kg/hr on the bases of MAP, maintaining at 70mmHg. Normal saline infusion 8 to 10 ml/kg/hr is continued in Group (P).The Heart Rate, Blood Pressure and MAP is measured every 5min throughout the surgery Bleeding during surgery was assessed by the surgeon, blinded to the study drugs intraoperatively and a bleeding severity score is given by the surgeon as a final personal opinion about the whole surgical process.RESULTS: Bleeding graded on the basis of the severity score was found to be higher in the placebo group than dexmedetomidine group. hemodynamic stability is also well maintained in dexmedetomidine group when compared with placebo group. The mean duration of surgery is also more in placebo group than dexmedetomidine group. Thus indicating that bleeding was less in the dexmedetomidine group with good hemodynamic stability and with decreased duration of surgery.CONCLUSION: This study concluded that intraoperative dexmedetomidine infusion provides a considerable reduction in bleeding, relatively dry operative filed , controlled hypotension improves visualization and allows the accurate delineation of lesions during FESS & Tympanoplasty under general anaesthesia.

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