Comparison of Dexmedetomidine-Isoflurane versus Fentanyl-Propofol based anesthesia for controlled hypotension in functional endoscopic sinus surgery

Abstract

Introduction: During functional endoscopic sinus surgery (FESS), effective control of bleeding is essentialto maintain a clear operative field and to minimize complications. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Study was designed to compare dexmedetomidine-isoflurane versus fentanyl-propofol based anesthesia in FESS surgery and to determine whether controlled hypotension and better operative conditions can be achieved when compared to each other. Methods: Prospective randomized study includes a total of 60 ASA I-II patients who underwent elective FESS surgery. Patients randomly assigned in two groups Dexmedetomidine-Isoflurane (DI) and Fentanyl-Propofol (FP). Intraoperative mean arterial pressure (MAP), heart rate (HR) and surgical grade of bleeding (based on Fromme-Boezzart scale) were recorded. Results and conclusion: This study demonstrated that Controlled hypotension can be achieved equally and effectively by both Dexmedetomidine- Isoflurane and Fentanyl-Propofol based anesthesia. Both are equally effective in providing ideal surgical field during FESS. MAP and heart rate were significantly higher at some occasion in FP group as compare to DI group.