Dexmedetomidine versus Nitroglycerin for Controlled Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery

Context: In patients with chronic sinusitis, Functional Endoscopic Sinus Surgery (FESS) is the preferred surgical option as part of treatment after conservative measures have failed. Aims: To improve the success of this surgery and to minimize complications, bloodless field is required. So our primary objective will be to provide bloodless field intraoperatively. Settings and design: Our study was a single blinded, prospective, randomized and comparative clinical study. It included forty adult patients between 18-60 years of age and of either sex. They all were from ASA Grade I & II. The patients were distributed into two groups of 20 each. Methods and material: Group D (n=20) Patients who received loading dose of Dexmedetomidine 1 microgram/ kilogram (μg/kg) over a period of 10 min before induction of anaesthesia and followed by maintenance infusion in the dose of 0.4-0.8 μg/kg/h after intubation via syringe infusion pump. Group N (n=20): Patients who received Inj. Nitroglycerine 5-10 μg/kg/min after intubation via continuous infusion. Patients were monitored for haemodynamic parameters, arterial oxygen saturation and end tidal CO2 at fifteen minute time interval. Average category scale score was used to assess the Quality of surgical field. Total amount of blood loss was noted. Statistical test used: Student's t-test Results: We observed statistically significant increase in mean pulse rate in the Nitroglycerine group as compared to the Dexmedetomidine group. Mean arterial pressure was successfully reduced to the target value in both the groups. There was no difference in amount of blood loss between the two groups. Conclusions: Dexmedetomidine and Nitroglycerine both can be used with great safety profile to achieve controlled hypotension during FESS.