Background and Objective: One of the main treatments for chronic rhinosinusitis is endoscopic surgery. In this procedure, intraoperative bleeding due to limited view of the surgeon can bring about surgical complications. To have a clear operation field for endoscopic sinus surgery, bleeding management is necessary. We aimed to compare the effects of magnesium sulfate and dexmedetomidine on operation field of candidates for endoscopic sinus surgery.
Materials and Methods: In this triple-blind clinical trial, 60 candidates for endoscopic sinus surgery were randomly divided into two groups of Dexmedetomidine and Magnesium sulfate. Before anesthesia, magnesium sulfate was administered for 10 min at a dose of 50 mg/kg and at a dose 15 mg/kg/h afterwards. In the other group, dexmedetomidine was given for 10 min before anesthesia at a dose of 1 mic/kg and at a dose of 0.6 mic/kg/h thereupon. The hemodynamic status of both groups was recorded 1, 5, 15, 30, and 60 min post-tracheal intubation. The results were analyzed using SPSS, version 16.
Results: In general, 20 (66.7%) patients in the Dexmedetomidine group and 18 (60.0%) patients in the Magnesium sulfate group were male (P=0.592). The mean ages of the Dexmedetomidine and Magnesium sulfate groups were 37.93 and 39.56 years, respectively (P=0.250). The mean surgical durations in the Dexmedetomidine and Magnesium sulfate groups were 79.03±41.8 min and 87.30± 15.09 min, respectively (P=0.003). Mean arterial pressure (MAP) in the Dexmedetomidine group was less than in the Magnesium Sulfate group at all the assessed times, except for the first time. The difference between the two groups was not significant only at first time. There was no statistical difference between the two groups in terms of mean saturation oxygen peripheral (SpO2) at all the recorded times. The mean intraoperative heart rate and mean pain intensity were lower in the Dexmedetomidine group than the Magnesium sulfate group. In the Magnesium sulfate group, odds ratio of bleeding in grade 3 to grade 2 was six times higher than the Dexmedetomidine group (OR= 6.00; 95% CI: 1.89, 19.1).
Conclusion: Dexmedetomidine is more beneficial for controlling hemodynamic status of sinus endoscopic surgery patients as it can provide a better operation field.