Comparison between Dexmedetomidine and Remifentanil for Controlled Hypotension and Recovery in Endoscopic Sinus Surgery. (July 2013)

• Record Type: Journal Article
• Authors: Lee, Jungah; Kim, Yongshin; Park, Chansoon; Jeon, Yeonsu; Kim, Daewoo; Joo, Jinduk; Kang, Hyerim
• Is Part Of: Annals of otology, rhinology & laryngology. Volume 122:Number 7(2013)
• Page Start: 421
• Page End: 426
• Publication Date: 2013-07
• Subjects: controlled hypotension -- dexmedetomidine -- endoscopic sinus surgery -- remifentanil; Otolaryngology -- Periodicals; 617.51
• DOI: 10.1177/000348941312200702
• Languages: English
• ISSNs: 0003-4894

Abstract

Objectives: We compared the efficacy of dexmedetomidine and remifentanil hydrochloride in intraoperative field conditions and recovery during endoscopic sinus surgery. Methods: Sixty-six patients (American Society of Anesthesiologists physical status I and II) scheduled for elective endoscopic sinus surgery were enrolled in this prospective, double-blinded, randomized study. The patients were randomly assigned to two groups. Propofol, 2 to 2.5 mg/kg, was administered to both groups to induce anesthesia, which was maintained with desflurane. One group received dexmedetomidine 1 μg/kg over 10 minutes at anesthesia induction, followed by 0.4 to 0.8 μg/kg per hour infusion during maintenance, whereas the other group received remifentanil 1 μg/kg over 1 minute at anesthesia induction, followed by 0.2 to 0.4 μg/kg per minute infusion during maintenance. Surgical conditions, hemodynamic parameters, intraoperative blood loss, time to extubation, sedation, and pain in the postanesthesia care unit (PACU) were recorded. Results: There were no significant differences between the two groups with respect to surgical field conditions, blood loss, or extubation time. The sedation score (Modified Observer's Assessment of Alertness/Sedation) in the PACU was significantly lower in the dexmedetomidine group than in the remifentanil group (p < 0.001). No differences were found in total blood loss, surgical field conditions, hemodynamic parameters, time to extubation, or pain in the PACU when the two groups were compared (p > 0.05). Conclusions: Although remifentanil and dexmedetomidine both enabled hypotensive anesthesia and good intraoperative fields for endoscopic sinus surgery, recovery was faster with remifentanil than with dexmedetomidine in the immediate postoperative period.