Comparative Evaluation of Propofol and Dexmedetomidine Infusion for Hypotensive Anesthesia During Functional Endoscopic Sinus Surgery: A Prospective Randomized Trial

Abstract

Background: Intense bleeding during general anesthesia is the major limitation during functional endoscopic sinus surgery. It affects operative eld visibility and increases complications. Hypotensive anesthesia is preffered to improve surgical outcomes. This study aimed to compare the efcacy of propofol and dexmedetomidine infusion for hypotensive anesthesia in patients undergoing FESS. To compare the efcacy Objective: and safety of dexmedetomidine and propofol for hypotensive anesthesia in functional endoscopic sinus surgeries. This Materials and methods: prospective randomized trial was conducted in 60 adult patients who were scheduled for FESS under general anesthesia. Patients were randomly divided into two groups: group P (n = 30) received propofol infusion of 50–150mcg/kg/min and group D (n = 30) received dexmedetomidine with a loading dose of 1 mcg/kg diluted in 10 mL 0.9% saline to be infused over 10 min after induction, followed by maintenance infusion of 0.4–0.8 mcg/kg/h. The infusions were titrated to maintain mean arterial pressure (MAP) between 60 and 70 mm Hg and hemodynamic stability. Intraoperative blood loss, quality of the surgical eld (Fromme- Boezaart scale), hemodynamic control, and patient recovery were recorded. Results: In our study, the mean arterial pressure and heart rate were signicantly lower in group D throughout the surgery than in group P. Blood loss was signicantly higher in group P (105.82 ± 15.16 ml) than in group D (90.50 ± 16.78 ml). The Fromme's score (Surgical eld visibility) 1/2/3 was comparable between the groups. The awakening time was signicantly short in group D than group P. Intraoperatively, only one incidence of bradycardia and hypotension was observed in group D (2.5%) compared to that in group P, which was managed successfully. In our Conclusion: study, we observed that both dexmedetomidine and propofol are efcacious and safe drugs for achieving controlled hypotension during FESS; however, dexmedetomidine provides better hemodynamic control and is associated with lesser degree of sedation without any signicant adverse effects.