Controlled Hypotension in Functional Endoscopic Sinus Surgery: A Comparison between Esmolol and Dexmedetomidine - A Randomized Prospective Study
Journal Title: International Journal of Contemporary Medical Research - Year 2018, Vol 5, Issue 2
Abstract
Introduction: Controlled hypotension is a tried and tested tool in minimizing blood loss, thus aiding haemodynamic stability intra-operatively. This study aims at comparing the efficacy of esmolol versus dexmedetomidine in achieving and maintaining controlled hypotension in Functional Endoscopic Sinus Surgery under General Anaesthesia. Material and Methods: All American Society of Anaesthesiologists Grade-I patients 20-45 years of age, admitted for Functional Endoscopic Sinus Surgery between January to September 2017, were enrolled in this prospective randomized study. The first patient was randomly allocated one of the drugs, and the subsequent patient was allocated the other drug alternately and so on. Dexmedetomidine was administered as a loading dose of 1 mcg/kg over 15 minutes intravenously, followed by 0.5 mcg/kg/min intravenously during maintenance. Esmolol was administered as a loading dose of 1 mg/kg intravenously over 1 minute followed by 0.5 mg/kg/min intravenously during maintenance. Extent and duration of controlled hypotension, visibility of operative field, and presence of any adverse effects were observed. Results: Out of the two drugs, esmolol was able to achieve satisfactory levels of controlled hypotension. It was associated with more haemodynamic stability, less required dosage and less incidence of adverse effects. However, it was seen that dexmedetomidine was able to cause profound sedation, analgesia and decreased dose requirements of other anaesthetic agents. Conclusion: Esmolol was found to be better suited for controlled hypotension in Functional Endoscopic Sinus Surgery than dexmedetomidine owing to better onset, maintenance and offset of hypotension; better quality of surgical field, and less incidence of adverse effects.
Authors and Affiliations
Kakati R, Borah P, Bhattacharyya RK, Deori AK
Keywords
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