scholarly journals Comparison of dexmedetomidine versus propofol-based anaesthesia for controlled hypotension in functional endoscopic sinus surgery

2019 ◽  
pp. 37-40
Author(s):  
DK Bharathwaj ◽  
SS Kamath
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Hypotension ◽  
Significant Difference ◽  
Group A ◽  
Group B

Background: Increased intraoperative bleeding during functional endoscopic sinus surgery (FESS) affects operative field visibility, which increases both duration of surgery and frequency of complications. Controlled hypotension is an anaesthetic technique in which there is deliberate reduction of systemic blood pressure during anaesthesia. The aim of the study was to compare the efficacy of dexmedetomidine against propofol infusion when used for controlled hypotension during FESS. Methods: A randomised, prospective, and single-blinded study was carried out, which included 80 patients of either sex of ASA grade І & ІІ who underwent elective FESS. Patients were randomly assigned to two groups: Group A (dexmedetomidine), Group B (propofol). Intraoperative mean arterial pressure (MAP), heart rate (HR), surgical grade of bleeding (based on the Fromme– Boezzart scale), and amount of bleeding were recorded. Results: Groups were well matched for their demographic data. There was a statistically significant difference (p < 0.05) between Group A and Group B in heart rate, mean arterial pressure (MAP) and mean total blood loss, with Group A being effectively in controlled on all three parameters during FESS. However, there was no significant difference (p > 0.05) in terms of surgical grade of bleeding between Group A and Group B. Conclusions: Both dexmedetomidine and propofol infusion are efficacious to facilitate controlled hypotension and haemodynamic stability intraoperatively.

scholarly journals Role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery in Private Practice

2020 ◽  
Vol 24 (1) ◽  
pp. 8-13
Author(s):  
Md Nurullah ◽  
Md Arif Hossain Bhuyan ◽  
Syed Ariful Islam ◽  
Md Shah Alam
Keyword(s):  
Heart Rate ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Hypotension ◽  
Operative Field ◽  
Group A ◽  
The Mean ◽  
Group B

Background: Functional endoscopic sinus surgery (FESS), effective control of bleeding is essential to maintain a clear operative field and to minimize complications. Intraoperative bleeding is one of the major problems in endoscopic surgery of sinuses. Controlled hypotension is a technique used to limit intraoperative blood loss to provide the best possible field for surgery. Objective: The objective of study was role of Hypotensive Anaesthesia in Functional Endoscopic Sinus Surgery and designed to compare intraoperative hemorrhage and the visibility of the operative field during normotension and hypotension anesthesia. Methods: Prospective randomized study includes a total of 60 ASA I-II patients who underwent elective FESS surgery. Patients randomly assigned in two groups the hypotension group (Group A) and the normotension group (Group B). Intraoperative mean arterial pressure (MAP), heart rate (HR) were recorded. Results : This study shows the mean ages of the patients of group A group B were 33.36±7.61 and 32.46±7.73 years respectively. No statistically significant difference was observed among groups at 0.05 level in term of age. The mean heart rate pre-anaesthesia and preoperative among the patients of different groups in different follows up period. Significance differences were observed among groups in term of heart rate at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. The mean arterial mean blood pressure before pre-anaesthesia and preoperative estimation among the patients of different groups in different follows up period. Significance differences were observed among groups at 5 minute, 15 minute, 30 minute, 45 minute and 60 minute. Conclusion: This study demonstrated that Controlled hypotension can be achieved equally and effectively by nitroglycerin and labetalol reduced significantly intraoperative hemorrhage and produce hypotensive anesthesia. Both are equally effective in providing ideal surgical field during functional endoscopic sinus surgery (FESS). Bangladesh J Otorhinolaryngol; April 2018; 24(1): 8-13

scholarly journals EFFICACY OF FUNCTIONAL ENDOSCOPIC SINUS SURGERY(FESS) IN TREATMENT OF POST NASAL DRIP (PND) AS AN ANCILLARY PROCEDURE: A COMPARATIVE STUDY

2021 ◽  
Vol 71 (Suppl-3) ◽  
pp. S573-76
Author(s):  
Saleem Asif Niazi ◽  
Shahzad Maqbool ◽  
Zafar Ullah Khan ◽  
Abdul Hakim ◽  
Muhammad Umair Aasim ◽  
...  
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Predominant Symptom ◽  
Postnasal Drip ◽  
Significant Difference ◽  
Quasi Experimental ◽  
Group A ◽  
Group B

Objective: To assess efficacy of functional endoscopic sinus surgery (FESS) in treatment of postnasal drip (PND) as an ancillary procedure to Septoplasty with Turbinoplasty. Study Design: Quasi experimental study. Methodology: Sample size was n-200, Patients were placed in two groups Group A (n-126) had septoplasty with turbineplasty. Group B (n-74) included patients with Septoplasty and Turbinoplasty combined with functional endoscopic sinus surgery. Post operative results regarding postnasal drip were compared amongst the Two groups. Results: Data was analysed in SPSS-17, Septoplasty along with turbinectomy was performed in n-126 patients (group A). And septoplasty, turbinectomy along with functional endoscopic sinus surgery was performed in n-74 patients (group B). Post nasal drip was significantly reduced in group B at 3 months follow up (p<0.046). More significant difference was noted at 6 months follow up (p<0.003). Conclusion: Patients having Chronic rhinosinusitis with postnasal drip as predominant symptom, should undergo functional endoscopic sinus surgery as an ancillary procedure to conventional nasal surgery.

scholarly journals Observation of the clinical efficacy of dexmedetomidine in flexible bronchoscopy under general anesthesia: clinical case experience exchange

2019 ◽  
Vol 47 (12) ◽  
pp. 6215-6222 ◽  
Author(s):  
Hongtu Li ◽  
Na Zhang ◽  
Ke Zhang ◽  
Yanhua Wei
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Adverse Events ◽  
Arterial Pressure ◽  
General Anesthesia ◽  
Recovery Time ◽  
Flexible Bronchoscopy ◽  
Stress Indices ◽  
Group A ◽  
Group B

Object To investigate the clinical efficacy and safety of dexmedetomidine in flexible bronchoscopy under general anesthesia. Methods A total of 114 patients were randomly divided into intervention group A and control group B. Group A received dexmedetomidine, fentanyl, and propofol as anesthesia, while Group B received fentanyl and propofol only. Changes in heart rate, mean arterial pressure, pulse oxygen saturation, stress indices (blood cortisol, adrenaline, and norepinephrine levels), incidence of adverse events, anesthesia dose, duration of procedure, and recovery time were compared between the groups at specific time points T0, T1, and T2 during bronchoscopy. Results There was no statistical difference between the groups at T0. At T1 and T2, pulse oxygen saturation, mean arterial pressure, heart rate, and stress indices in group A were significantly more favorable than those in group B. The incidence of adverse events (5.26%) in group A was significantly lower than that in group B (17.54%), and patients in group A required less propofol and had a faster recovery time than patients in group B. Conclusion Dexmedetomidine use in flexible bronchoscopy under general anesthesia is safe and effective and decreases the stress response in synergy with propofol to provide hemodynamic stability.

scholarly journals Impact of septoplasty alone or with endoscopic sinus surgery for treatment of chronic rhinosinusitis with deviated septum

2021 ◽  
Vol 37 (1) ◽  
Author(s):  
Soad Yehia Mostafa ◽  
Fatma Mohamed Abd-Elgaber ◽  
Bothina Ahmed Mohamed ◽  
Al-Shimaa Said Hammad
Keyword(s):  
Chronic Rhinosinusitis ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Septal Deviation ◽  
Sinus Surgery ◽  
Osteomeatal Complex ◽  
Group A ◽  
Group B ◽  
Mucosal Thickening

Abstract Background Chronic rhinosinusitis represents an important health care problem in the world. Deviated nasal septum leads to increased chance of impaired mucociliary clearance, osteomeatal complex obstruction, and development of rhinosinusitis. Studies have revealed the role of septoplasty in curing chronic rhinosinusitis in patients with significant septal deviation. The purpose of this study is to reveal the role of septoplasty alone or combined with functional endoscopic sinus surgery in improving the outcome of chronic rhinosinusitis in patients with significant septal deviation. Results Postoperative computed tomography findings in group A (underwent septoplasty only) were mild opacity of ethmoid (25%), sinus mucosal thickening (15%), and occluded osteomeatal complex with discharge (25%). Postoperative computed tomography findings in group B mild opacity of ethmoid (30%), sinus mucosal thickening (20%), and occluded osteomeatal complex with discharge (30%). The Sino-Nasal Outcome Test score in group A decreased significantly from 85.75 to 28.85 (P < 0.05). In group B (underwent combination of septoplasty and functional endoscopic sinus surgery), the Sino-Nasal Outcome Test score also decreased significantly from 87.75 to 32.55 (P < 0.05). The improvement was 85% in group A and 80% in group B. Conclusion The post-operative improvement has no significant difference between the two groups. Hence, we suggest that septoplasty alone can be adequate for the treatment of chronic rhinosinusitis with septal deviation.

EFFECT OF PREOPERATIVE STEROIDS ON PERIOPERATIVE AND POSTOPERATIVE HAEMORRHAGE IN PATIENTS UNRERGOING FESS AT SKMCH, MUZAFFARPUR, BIHAR

2021 ◽  
pp. 40-41
Author(s):  
Khushbu Rani ◽  
Mrinalini Raman ◽  
Pawan Kumar Lal ◽  
Debarshi Jana
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Chronic Sinusitis ◽  
Postoperative Hemorrhage ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Control Group ◽  
Early Recovery ◽  
Postoperative Haemorrhage ◽  
Group A ◽  
Group B

Objective: To compare the effect of preoperative oral steroids (prednisolone) on perioperative and postoperative hemorrhage in patients undergoing functional endoscopic sinus surgery for chronic sinusitis with those who do not receive steroids. Design:Randomized controlled trials. Place and duration of study:This study was conducted in ENT Department of Sri Krishna Medical College and Hospital (SKMCH), Muzaffarpur, Bihar from April 2020 to March 2021. Material and Methods: After getting informed consent total of 60 patients who fullled the inclusion criteria were selected and functional endoscopic sinus surgery was carried out. They were divided into two groups of 30 each by using random number tables. Group A received prednisolone in a dose of 01 mg/kg body weight for 01 week prior to surgery (last day of dose being the day prior to operative day) while group B (control group) did not receive any steroid. Results:There was a signicant difference in both perioperative and postoperative hemorrhage with better control rates in group A. Conclusion: Prednisolone given preoperatively signicantly reduces the morbidity that is perioperative and postoperative hemorrhage thus early recovery to normal life style in patients undergoing functional endoscopic sinus surgery for chronic sinusitis.

scholarly journals Comparison of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery for chronic rhinosinusitis with nasal polyps

2019 ◽  
Vol 9 (34) ◽  
pp. 91-95
Author(s):  
Ramiya Ramachandran Kaipuzha ◽  
Nirmal Coumare Venkataramanujam ◽  
Padmanabhan Karthikeyan ◽  
Davis Thomas Pulimoottil
Keyword(s):  
Endoscopic Sinus Surgery ◽  
Mucosal Injury ◽  
Sinus Surgery ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Time ◽  
Sinonasal Polyposis

AbstractOBJECTIVE. To study and compare the benefits of microdebrider-assisted endoscopic sinus surgery and conventional endoscopic sinus surgery in terms of subjective and objective improvement in symptoms of nasal polyposis.MATERIAL AND METHODS. This study involved 60 patients with bilateral sinonasal polyposis scheduled to undergo Endoscopic Sinus Surgery. The patients were randomized into two groups: Group A -Conventional endoscopic sinus surgery and Group B -Microdebrider-assisted endoscopic sinus surgery.RESULTS. There was a significant difference in the mean VAS at 3 months postoperatively in Group B, but no significant difference at 6 months postoperatively following either of the two methods. The mean time for surgery (p<0.01) and the mean intraoperative blood loss (p<0.01) were significantly lower in Group B.CONCLUSION. A well-trained surgeon with proper anatomical knowledge, good instruments, hypotensive anaesthesia, minimal mucosal injury and regular proper follow-up will have similar postoperative results with both methods.

scholarly journals Prospective randomised control study of dexmedetomidine for controlled hypotension in functional endoscopic sinus surgery

2021 ◽  
Author(s):  
Mahendran K. ◽  
Rasika Priya
Keyword(s):  
Mean Arterial Pressure ◽  
Endoscopic Sinus Surgery ◽  
Functional Endoscopic Sinus Surgery ◽  
Sinus Surgery ◽  
Controlled Hypotension ◽  
The Awakening ◽  
Duration Of Surgery ◽  
Surgical Field ◽  
Group D ◽  
Dexmedetomidine Infusion

<p class="abstract"><strong>Background: </strong>Functional endoscopic sinus surgery is one of the commonly performed Surgeries. Induced hypotension is a method employed in functional endoscopic sinus surgery to reduce blood loss and to improve the visibility of the surgical field. This study aimed to evaluate the effect of dexmedetomidine infusion on the requirement of Isoflurane to produce controlled hypotension (mean arterial pressure of 60-70 mmHg), quality of the bloodless surgical field, duration of surgery, and the awakening time in patients undergoing Functional endoscopic sinus surgery (FESS).</p><p class="abstract"><strong>Methods: </strong>50 patients were divided into Group D, Group C Group D. After successful tracheal intubation, anesthesia was maintained with 66% nitrous oxide + 33% oxygen + isoflurane titrated to achieve a mean arterial pressure (MAP) of 60-70 mmHg. Isoflurane and dexmedetomidine/saline infusion was stopped 10-15 minutes before the end of surgery. The intraoperative surgical field was assessed by using a 6 points Fromme-Boezaart scale.</p><p class="abstract"><strong>Results:</strong> A statistically significant (p&lt;0.001) reduction in intraoperative isoflurane requirement in patients receiving dexmedetomidine infusion (0.387±0.102) in comparison to those receiving placebo (1.7±0.211). Both the group provided better visualization of the surgical field. The duration of surgery was statistically (p=0.004) low in Group D (76.84±14.174) compared to group C (94.1±25.083). The awakening time in min was statistically (p=0.001) low in group D (5.12±1.691) compared to group C (9.72±1.100).</p><p class="abstract"><strong>Conclusions: </strong>Dexmedetomidine infusion helps in achieving a targeted reduction in MAP reduced intraoperative Isoflurane requirement, better bloodless field, and faster awakening in patients undergoing Functional endoscopic sinus surgery.</p>

scholarly journals A Comparative Study between Two Different Doses of Dexmedetomidine for Attenuation of Hemodynamic Response to Laryngoscopy and Tracheal Intubation.

2019 ◽  
Vol 21 (3) ◽  
pp. 178-183
Author(s):  
Chitra Thapa ◽  
S. Gauchan
Keyword(s):  
Blood Pressure ◽  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Tracheal Intubation ◽  
Arterial Pressure ◽  
Systolic Blood Pressure ◽  
Study Drug ◽  
Hemodynamic Response ◽  
Group A ◽  
Group B

Laryngoscopy and end tracheal intubation are stressful situation for the patients, as these procedures are capable of producing tachycardia, hypertension and arrhythmias. This study was conducted with the objective of arriving at an optimal dose of dexmedetomidine that can attenuate the hemodynamic response to laryngoscopy and intubation with minimal side effects. The current study was conducted in 60 patients, posted for elective surgery under general anesthesia withendotracheal intubation. The patients were divided into two groups: Group A and Group B. Group A received dexmedetomidine 0.5 μg/kg and group B received dexmedetomidine 1 μg/kg intravenously over 10 min prior to induction of anesthesia. The anesthesia technique was standardized in both the groups. Heart rate, systolic, diastolic and mean arterial pressure were monitored and recorded at 5min and 10 min of completion of infusion of study drug, after induction, and at 1 min, 2 min, 5 min after intubation. The baseline heart rate, systolic blood pressure, diastolic blood pressure and mean arterial pressure were statistically similar in both the groups. After the infusion of the study drug the mean heart rate, mean systolic blood pressure, mean diastolic blood pressure, mean arterial pressure at all times were comparable in both the groups. Episodes of hypotension and bradycardia were also statistically similar in both the groups. Attenuation of hemodynamic response to laryngoscopy and intubation by dexmedetomidine is similar with the two doses: 0.5  μg/kg and 1 μg/kg. Both the doses of dexmedetomidine were devoid of any significant adverse effects.

scholarly journals Role of intravenous esmolol, fentanyl and lignocaine for attenuation of stress response in tracheal intubation - a comparative study

2014 ◽  
Vol 26 (1) ◽  
pp. 12-19
Author(s):  
Nurul Islam ◽  
Amirul Islam ◽  
Idris Ali ◽  
Mohiuddin Shumon ◽  
Mozaffor Hossain ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Endotracheal Intubation ◽  
Haemodynamic Response ◽  
Rate Pressure Product ◽  
Mean Values ◽  
Group A ◽  
The Mean ◽  
Group B

Background Endotracheal intubation is an essential part of safe airway management but this stimulates the patient’s airway reflexes and predictably leads to haemodynamic derangement. Many drugs have been suggested in modifying in haemodynamic responses to laryngoscopy and intubation. Objectives To assess efficacy of three drugs - esmolol, fentanyl and lignocaine and to assess which one is more effective to attenuate haemodynamic response to direct laryngoscopy and endotracheal intubation. Methods A total number of 90 patients ASA class I and II were selected randomly as per inclusion and exclusion criteria in three groups, 30 patients in each group. Group A received esmolol 1.5mg/kg in the volume of 10ml (with distil water) 2min before intubation, group B received fentanyl 1.5mg/kg IV 5min before intubation and group C received lignocaine 1.5mg/kg IV 90 sec before intubation. Per-operative data were recorded at 1min, 2min, 5min and 10min after intubation. Results The mean heart rate, systolic, diastolic,mean arterial pressure before starting anaesthesia were similar in group-A (esmolol), B(fentanyl) and C(lignocaine). The mean values of heart rate and rate pressure product were significantly lower in group A(Esmolol) at 1 and 2 minute than group B(fentanyl) and at 1, 2 and 5 minute than group C(lignocaine). The mean values of systolic, diastolic and mean arterial pressure were slightly lower in group A(esmolol) at 5 minute than group B(fentanyl) and significantly lower at 1, 2 and 5 minute than group C(lignocaine). Conclusion Esmolol 1.5mg/kg is superior to lignocaine 1.5mg/kg for attenuation of haemodynamic response (HR, SBP, DBP, RPP and MAP) to laryngoscopy and endotracheal intubation and also superior to fentanyl for attenuation of HR and RPP. DOI: http://dx.doi.org/10.3329/jbsa.v26i1.19810 Journal of Bangladesh Society of Anaesthesiologists 2013; 26(1): 12-19  

scholarly journals Effect of Pregabalin Use as Preemptive Analgesia after Abdominal Hysterectomy on Heart Rate and Arterial Pressure

2017 ◽  
Vol 2 (2) ◽  
pp. 98-102
Author(s):  
Kazi Nur Asfia ◽  
Moinul Hossain ◽  
AKM Aktaruzzaman ◽  
Mostofa Kamal ◽  
Mohammad Abdullah Yusuf ◽  
...  
Keyword(s):  
Heart Rate ◽  
Mean Arterial Pressure ◽  
Arterial Pressure ◽  
Abdominal Hysterectomy ◽  
Preemptive Analgesia ◽  
Study Group ◽  
Group A ◽  
The Mean ◽  
Group B ◽  
Mean Heart Rate

Background: Effect of pregabalin on heart rate and arterial pressure is important in its use as preemptive analgesia. Objective: The purpose of the present study was to evaluate the effect of pregabalin use as preemptive analgesia after abdominal hysterectomy on heart rate and arterial pressure.Methodology: This randomized double-blind placebo-controlled clinical trial was conducted in the Department of Anesthesia, Analgesia and Intensive Care Medicine, Banghabandhu Sheikh Mujib Medical University, Dhaka from July 2010 to June 2012 for a period of two years. Women aged between 40-60 years scheduled for abdominal hysterectomy under sub-arachnoid block were selected as study population for this study. A total of one hundred and twenty women meeting the above mentioned criteria were randomly allocated into two equal groups by card sampling. 120 cards, 60 for each group were prepared by another person who was not aware of the study. Group A was known as study group who were received 300mg oral pregnabin one hour before performance of SAB and group B was known as control group who were received matching placebo one hour before SAB. The patients were examined preoperatively and preoperative baseline parameters including heart rate, mean arterial pressure were recorded immediately before sub-arachnoid block (SAB). Patients were visited by the investigators at ½, 1, 2, 4, 12, and 24 h after operation. In each visit, heart rate and mean arterial pressure were measured and were recorded. Result: The present study was conducted on 120 women undergoing abdominal hysterectomy. Of them, 60 received preemptive single oral doses (300mg) Pregabalin (Group A) and the rest 60 received matching placebos (Group B) 1hr before surgery. The mean heart rate with SD before SAB was 79.4±4.7 and 90.5±5.7 in group A and B respectively (p=0.011). After 24 hours of operation the mean heart rate with SD was 73±5 and 85±4 in group A and B respectively (p= 0.043). The mean arterial pressure with SD before SAB was 94.3±5.3 and 95.8±20.4 in group A and B respectively (p=0.569). After 24 hours of operation the mean arterial pressure with SD was 89.4±4.45 and 96.1±2.56 in group A and B respectively (p <0.001). Conclusion: In conclusion the mean heart rate and arterial pressure are statistically significantly changes in the women after abdominal hysterectomy to whom pregabalin is used as preemptive analgesia. Journal of National Institute of Neurosciences Bangladesh, 2016;2(2): 98-102

Sign in / Sign up

Export Citation Format

Share Document