Prospective Observational Study to Assess Controlled Hypotension Using Dexmedetomidine and Magnesium Sulphate Among Patients Undergoing Functional Endoscopic Sinus Surgery(Fess) in Tertiary Care Hospital

Abstract

AIM

Functional endoscopic sinus surgery (FESS) is done in closed space and bleeding becomes a major determinant for visibility. Stimulation of nasal mucosa and pharyngeal tissue causes a centrally mediated sympathetic reaction that results in hemodynamic response during the procedure. Aim of our study is to observe time taken to achieve 20 % decrease in MAP from baseline mean arterial pressure and to observe circulatory response to tracheal intubation and extubation.

MATERIALS AND METHODOLOGY:

A prospective randomized observational study conducted at our hospital for a period of 1 year from January 2023 onwards.

96 patients were selected for the study after applying inclusion and exclusion criteria. As per the deision of the consultant anesthetist patients  received either Inj.Dexmeditomidine 1mcg/kg as loading dose in 100 ml NS over 10 mins before induction of anesthesia and maintenance dose of 0.5-1 mcg/kg administered after induction of anesthesia or Inj.Magnesium sulphate 40mg/kg as loading dose in 100ml NS over 10 mins before induction of anesthesia and maintenance dose of 10-15 mg/kg after induction of anesthesia. Hemodynamic status pre induction, post induction at 3 mins,5 mins,15 mins,45 mins and 5 mins post extubation was observed.

• RESULTS:

In this study involving 96 patient undergoing FESS. Dexmedetomidine was found to be a better hypotensive agent compared to magnesium sulphate by reducing heart rate and mean arterial pressure by 20%.

• CONCLUSION:

We concluded that dexmedetomidine when used in above mentioned doses produced early onset and sustained controlled hypotension that is more significant than magnesium sulphate in patients undergoing FESS. Dexmedetomidine is a better agent to blunt tracheal response than magnesium sulphate without causing pronounced complications.