Comparing Magnesium Sulfate and Dexmedetomidine in Controlled Hypotension During Endoscopic Sinus Surgery: A Prospective Randomized Study

Abstract

BACKGROUND: Functional endoscopic sinus surgery (FESS) has been proposed as a selected treatment used in patients with chronic sinusitis. Due to the nature of the location of endoscopic sinus surgery, even a small amount of bleeding can reduce the operative visibility and thus cause surgeon dissatisfaction and prolong the operation trauma. The aim of the work was to compare dexmedetomidine and magnesium sulfate regarding their efcacy as a hypotensive agent in FESS to obtain a bloodless surgical eld. METHODS: A randomized, prospective comparative study and was conducted in the Department of Anesthesia, Government Medical College, Jammu, J&K, for a period of 6 months, on sixty patients, aged between 18 and 60 years, of both genders, and assigned into two equal groups: magnesium sulfate group and dexmedetomidine group. RESULTS: Dexmedetomidine controlled blood pressure better than magnesium sulfate as nitroglycerin was added to achieve the targeted MAP in the Group M. There was a statistically signicant decrease in the MAP among Dexmedetomidine Group 58.07 ± 3.83 mmHg compared to Magnesium Sulfate Group 66.58 ± 3.96 mmHg at 30 minutes and similarly at 60 minutes, post-extubation and postoperatively. There was a statistically signicant decrease in the HR at 30 minutes and later, as also in the amount of blood loss (p = 0.019). The surgeon satisfaction was signicantly higher in Group D than in Group M. CONCLUSION: Dexmedetomidine can provide more effective controlled hypotension and thus contribute to improved visibility of the surgical site.