Guven Damla Guclu, Demiraran Yavuz, Sezen Gulbin, Kepek Okkes, Iskender Abdulkadir
Department of Otorhinolaryngology, Duzce University School of Medicine, Duzce, Turkey.
Ann Otol Rhinol Laryngol. 2011 Sep;120(9):586-92. doi: 10.1177/000348941112000906.
We aimed to evaluate the effects of dexmedetomidine hydrochloride (DEX) on hemodynamic parameters and on surgeon and patient satisfaction during functional endoscopic sinus surgery (FESS).
Forty patients who were to undergo FESS were enrolled in this randomized, prospective, controlled study. In the DEX group, conscious sedation was induced with an infusion of 1 microg/kg of DEX 10 minutes before surgery, followed by an infusion of DEX at 0.2 microg/kg per hour. A control group was given identical amounts of saline solution. During the procedure, hemodynamic data were recorded. The patients evaluated their pain on a visual analog scale (VAS). Intraoperative bleeding was rated on a 6-point scale for evaluation of operative field visibility.
We observed that the DEX group had lower bleeding scores (p = 0.019). The heart rates were lower in the DEX group at the time of induction (p = 0.052) and in the 1st (p = 0.009) and 20th minutes (p = 0.039) of induction. The mean blood pressure values were lower in the DEX group in the 5th (p < 0.001), 45th (p = 0.003), and 60th (p = 0.05) minutes of induction. The VAS score was lower in the DEX group in the 30th postoperative minute (p = 0.001); however, the VAS score was lower in the control group after the 12th hour (p < 0.001). Postoperative side effects such as nausea, tachycardia, hypotension, and vomiting were significantly less frequent in the DEX group (p < 0.001).
We observed that the intraoperative bleeding, hemodynamic stability, and VAS scores were better and the side effects were less frequent in the DEX group.
我们旨在评估盐酸右美托咪定（DEX）对功能性内镜鼻窦手术（FESS）期间血流动力学参数以及外科医生和患者满意度的影响。
40例拟行FESS的患者纳入了这项随机、前瞻性、对照研究。DEX组在手术前10分钟静脉输注1μg/kg的DEX诱导清醒镇静，随后以0.2μg/（kg·小时）的速度持续输注。对照组给予等量的生理盐水。术中记录血流动力学数据。患者使用视觉模拟评分法（VAS）评估疼痛程度。术中出血情况按6分制进行评分以评估术野清晰度。
我们观察到DEX组的出血评分较低（p = 0.019）。诱导时DEX组的心率较低（p = 0.052），诱导后第1分钟（p = 0.009）和第20分钟（p = 0.039）也是如此。诱导后第5分钟（p < 0.001）、第45分钟（p = 0.003）和第60分钟（p = 0.05），DEX组的平均血压值较低。术后第30分钟DEX组的VAS评分较低（p = 0.001）；然而，术后12小时后对照组的VAS评分较低（p < 0.001）。DEX组术后恶心、心动过速、低血压和呕吐等副作用明显较少（p < 0.001）。
我们观察到DEX组术中出血、血流动力学稳定性和VAS评分更佳，且副作用较少。
