Anesth Pain Med.  2022 Jul;17(3):271-279. 10.17085/apm.21118.

Comparative evaluation of propofol versus dexmedetomidine infusion for hypotensive anesthesia during functional endoscopic sinus surgery: a prospective randomized trial

• Gupta KK
• Kumari V
• Kaur S
• Singh A

• KMID: 2535319
• DOI: http://doi.org/10.17085/apm.21118

Abstract

Background
During functional endoscopic sinus surgery (FESS), intranasal bleeding affects operative field visibility and increases the frequency of complications. Therefore, hypotensive anesthesia is a widely used technique to improve surgical outcomes. This study aimed to compare the efficacy of propofol and dexmedetomidine infusion for hypotensive anesthesia in patients undergoing FESS. Methods: This prospective randomized trial was conducted in 80 adult patients who were scheduled for FESS under general anesthesia. Patients were randomly divided into two groups: group P (n = 40) received propofol infusion of 100–200 µg/kg/min and group D (n = 40) received dexmedetomidine infusion with a loading dose of 1 µg/kg over 10 min after induction, followed by maintenance infusion of 0.4–0.8 µg/kg/h. Intraoperative blood loss, quality of the surgical field (Fromme- Boezaart scale), hemodynamic control, and patient recovery were recorded. Statistical analysis was performed using Student’s t-test, chi-square test, and Mann–Whitney U test. Results: The mean arterial pressure and heart rate were significantly lower in group D throughout the surgery than in group P. Blood loss was significantly higher in group P (100.73 ± 18.12 ml) than in group D (85.70 ± 18.56 ml). The average number of patients with Fromme’s score 1/2/3 was comparable between the groups. Intraoperatively, only one incidence of bradycardia and hypotension was observed in group D (2.5%) compared to group P. Conclusions: Both dexmedetomidine and propofol are efficacious and safe drugs for facilitating controlled hypotension during FESS; however, dexmedetomidine provides better hemodynamic control and is associated with lesser blood loss without any significant adverse effects.

Keyword

Dexmedetomidine; Functional endoscopic sinus surgery; Hypotensive anesthesia; Propofol.

Figure

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  Fig. 1. CONSORT flow diagram. CONSORT: consolidated standards of reporting trials.

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  Fig. 2. Intraoperative mean blood loss (ml). Values are presented as mean ± SD.

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  Fig. 3. Intraoperative heart rate (beats/min).

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  Fig. 4. Intraoperative mean arterial pressure (MAP) (mmHg).

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