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Our aim was to study the effects of dexmedetomidine on anesthetic consumption, duration of surgery, time to extubation and post-operative emergence when used as an adjunct to general anesthesia in endoscopic nasal surgeries. Fifty two patients scheduled for elective nasal surgery (Functional Endoscopic Sinus Surgery and Functional Endoscopic Nasal surgery) were randomized into two groups. Dexmedetomidine-group (D) and placebo or control-group (C). Dexmedetomidine was administered to the D group at a bolus dose of 0.5 ug/kg via an intravenous infusion pump over 10 min. Intraoperative maintenance was supplied by a continuous infusion of 0.2 ug/kg/hr. Infusion of Dexmedetomidine was stopped when the major surgical intervention was over. Group C was given equal amounts of normal saline, instead of Dexmedetomidine. The intraoperative hemodynamics during the surgery were recorded on a proforma. The duration of surgery, time to extubation and amount of anesthetic agents consumed in both the groups were noted. We found that there was a statistically significant difference in anesthetic consumption between both groups. The time to extubation was more in group C(p value < 0.05) .Awakening scores were better in group D(p value < 0.05).No significant difference in the duration of surgery was found.Our conclusion was that Dexmedetomidine reduces anesthetic agent consumption significantly when used as an adjunct in endoscopic nasal surgeries, thereby leading to shorter extubation times and better awakening scores.

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Anesthetic management of patients with coronary artery disease undergoing noncardiac surgery is quite challenging. Such patients are at increased risk of perioperative cardiac complications and death. We report an illustrative case of a 62-year-old male with ischemic heart disease and anomalous coronary arteries for obstructed paraumbilical hernia repair.

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