Comparative evaluation of clinical outcomes of dexmedetomidine versus without dexmedetomidine in surgical field of otorhinolaryngology: A prospective study

Abstract

Introduction: This prospective study aims to systematically compare the clinical outcomes of dexmedetomidine versus without dexmedetomidine in the context of nasal procedures. Dexmedetomidine is an Alpha-2 adrenergic agonist with sedative and analgesic properties. The research seeks to evaluate the impact of dexmedetomidine administration on surgical outcomes and patient safety. Objective: Our research’s objective was to evaluate the clinical outcomes of a bolus dose of dexmedetomidine during nasal surgery in the range of 0.5–1 µg/kg followed by maintenance infusion of dexmedetomidine at a dose of 0.2–0.5 µg/h compared to without dexmedetomidine. Materials and Methods: This study is characterized as a prospective, observational, and comparative investigation. After institutional ethical committee approval, informed consent was obtained and 60 patients were split into two groups of 30 each. Group A received a dexmedetomidine bolus dose of 0.5–1 µg/kg diluted over 10 min in 0.9% normal saline followed by maintenance infusion of dexmedetomidine at 0.2–0.5 µg/h. Group B received routine anesthesia. In both the groups, infusions were titrated to maintain controlled hypotension. During the surgery, the bleeding score was determined using the Boezaart scale. Results: In this study, it was observed that Group A had lower intraoperative blood pressure (BP), heart rate (HR), and mean arterial pressure which significantly reduced the overall bleeding score. In the dexmedetomidine group, the average Boezaart score was 2.0, and in Group B, it was 2.47. Both the groups experienced intraoperative complications in which medical intervention was carried out. Compared to Group B, Group A maintained better hypotension, eliminating both intraoperative and postoperative anxiety. Postoperatively BP, HR, respiratory rate, and SpO2 were monitored till 5 h, and we found a significant difference (P < 0.05) between both the groups, where Group A demonstrated better hemodynamic stability. Conclusion: The dexmedetomidine group demonstrated a substantial decrease in HR, mean atrial pressure, and intraoperative BP, resulting in a surgical field devoid of blood and with a lower bleeding grade. Postoperative problems were less common when dexmedetomidine was used.