Intranasal Dexmedetomidine as Adjuvant to Local Anaesthetic in Preparation of Nasal Passage for Functional Endoscopic Sinus Surgery: Randomized Controlled Trial

Jyoti Vishnu  Kale; Neha Amey Panse; Priyanka Gangathade; Aniket Shete

doi:10.18502/aacc.v10i1.14772

Jyoti Vishnu Kale Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India.
Neha Amey Panse Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India.
Priyanka Gangathade Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India.
Aniket Shete Department of Anesthesia, Smt. Kashibai Navale Medical College and General Hospital, Pune, India.

DOI: https://doi.org/10.18502/aacc.v10i1.14772

Keywords: Dexmedetomidine; Functional endoscopic sinus surgery (FESS); Local anesthetics

Abstract

Background: Intraoperative stress response and ongoing bleeding at surgical site especially in areas like head and neck can cause serious adverse reactions and affect the postoperative outcome. This study compared the effect of intranasally administered dexmedetomidine (dexmed) in combination with local anesthesia (LA) and local anesthetic alone on quality of surgical field, surgical bleeding and haemodyanamic parameters during functional endoscopic sinus surgery (FESS).

Methods: Roller gauge strips dipped in dexmedetomidine were used for nasal packing. Sixty patients undergoing FESS were randomly allocated to receive either intranasal Dexmedetomidine with LA (D group) or intranasal LA alone (L group) via nasal packing 15 min before surgery. The primary objective was to study the quality view of surgical field through the endoscope and the blood loss that occurred while raising the nasal mucosal flap. The secondary objective was to study the intraoperative hemodynamic profile and anesthetic and analgesic requirement during surgery.

Results: Surgical field quality, Blood loss, hemodynamic profile and satisfaction scores of patients and surgeons were significantly better (P< 0.05) in dexmed group.

Conclusion: Patients receiving intranasal dexmed with LA for FESS had better surgical field, surgeon’s satisfaction and minimal hemodynamic fluctuations with lesser blood loss as well as better postoperative comfort and analgesia.