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Dexmedetomidine improves the quality of the operative field for functional endoscopic sinus surgery: systematic review

Published online by Cambridge University Press:  05 June 2015

K Snidvongs ,
W Tingthanathikul ,
S Aeumjaturapat  and
S Chusakul
K Snidvongs*
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok
W Tingthanathikul
Affiliation:
Department of Anesthesiology, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
S Aeumjaturapat
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok
S Chusakul
Affiliation:
Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok
*
Address for correspondence: Dr Kornkiat Snidvongs, Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok 10330, Thailand Fax: +66 2 252 7787 E-mail: drkornkiat@yahoo.com
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Abstract

Background:

Intra-operative bleeding diminishes visualisation during functional endoscopic sinus surgery and can cause unfavourable outcomes. Dexmedetomidine is a potent alpha-2 agonist, with sympatholytic effects. This systematic review aimed to assess whether dexmedetomidine decreases intra-operative bleeding and improves operative field quality.

Methods:

All randomised, controlled trials that assessed the ability of dexmedetomidine to provide good operative fields for functional endoscopic sinus surgery were identified from Medline and Embase. The outcomes of interest were: operative field quality, intra-operative bleeding, operative time and adverse events.

Results:

Five studies (254 patients) met the inclusion criteria. When compared to saline, dexmedetomidine improved the quality of the operative field. The operative time was similar between groups. When compared to other drugs, dexmedetomidine was as effective as esmolol and remifentanil. There were no adverse incidents.

Conclusion:

Dexmedetomidine is beneficial in providing good visibility during functional endoscopic sinus surgery. Controlled hypotensive anaesthesia with this medicine decreases intra-operative bleeding and enhances surgical field quality.

Keywords

DexmedetomidineParanasal SinusesSinus Surgery
Type
Review Articles
Information
The Journal of Laryngology & Otology , Volume 129 , Supplement S3 , July 2015 , pp. S8 - S13
Copyright
Copyright © JLO (1984) Limited 2015 

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