Comparative study between Dexmedetomidine, magnesium sulfate and propofol in controlled hypotensive anesthesia during endoscopic sinus surgery

Abstract

Background: The use of controlled hypotension has been shown to enhance the operational field visibility and reduce many surgical factors such as total blood loss, surgery duration and the occurrence of ecchymosis and postoperative edema. The objective of this research was to assess and evaluate the effectiveness of propofol, magnesium sulfate, and Dexmedetomidine in inducing controlled hypotensive anesthesia for Functional Endoscopic Sinus Surgery (FESS). Methods: The use of controlled the current research had a prospective randomized double-blind design and included a sample of sixty individuals aged between twenty-one and fifty years, including both genders. The participants were having FESS. The participants were classified into three distinct groups. In the first group, participants were administered Dexmedetomidine intravenously at a loading dosage of 0.5 micrograms per kilogram, followed by a maintenance dose ranging from 0.2 to 0.4 mcg/kg/hour. The second group got an intravenous dose of forty mcg\kg of magnesium sulfate, with a maintenance dose ranging from ten to fifteen mcg/kg/hour. Lastly, the third group received an intravenous dose of two hundred mg per twenty ml of propofol, with a maintenance dose ranging from two to four mcg/kg/hour. These administrations were carried out continuously during the surgical procedure. Results:The research observed a substantial decline in the visibility and bleeding score within group one compared to group two. However, there was no important variance in the visibility and bleeding score between group one and group three. Additionally, the research found a significant elevate in the visibility and bleeding score within group two compared to group three. The bradycardia incidence and the need for atropine were higher in patients receiving propofol and Dexmedetomidine. There was no bradycardia or atropine needed with group two. Side effects as nausea, shivering, and vomiting were less with propofol and Dexmedetomidine than with group two. Conclusions: The efficacy of Dexmedetomidine is better than MgSO4 and propofol and for controlled hypotension during FESS.