Effectiveness of dexmedetomidine in reducing bleeding during septoplasty and tympanoplasty operations

• Published in: Journal of clinical anesthesia Vol. 20; no. 6; pp. 437 - 441
• Main Authors: Ayoglu, Hilal, MD, Yapakci, Osman, MD, Ugur, Mehmet Birol, MD, Uzun, Lokman, MD, Altunkaya, Hanife, MD, Ozer, Yetkin, MD, Uyanik, Rahsan, MD, Cinar, Fikret, MD, Ozkocak, Isil, MD
• Format: Journal Article
• Language: English
• Published: New York, NY Elsevier Inc 01-09-2008; Elsevier Science; Elsevier Limited
• Subjects: Adolescent; Adrenergic alpha-Agonists - pharmacology; Adult; Aged; Analgesics; Analgesics, Opioid - therapeutic use; Anesthesia; Anesthesia & Perioperative Care; Anesthesia. Intensive care medicine. Transfusions. Cell therapy and gene therapy; Biological and medical sciences; Blood Loss, Surgical - prevention & control; Blood Pressure - drug effects; Cardiovascular disease; Controlled hypotension; Dexmedetomidine; Dexmedetomidine - pharmacology; Double-Blind Method; Drug dosages; Evacuations & rescues; Female; Fentanyl - therapeutic use; Hematocrit; Humans; Male; Medical sciences; Middle Aged; Nasal Septum - surgery; Pain Medicine; Surgery; Surgery: Otorhinolaryngology; Tympanoplasty; Surgery: Otorhinolaryngology; Dexmedetomidine; Controlled hypotension; α2-Adrenergic receptor; Agonist; Surgery; Anesthesia; α-Adrenergic receptor agonist; Otorhinolaryngology; Hemorrhage
• ISSN: 0952-8180; 1873-4529
• DOI: 10.1016/j.jclinane.2008.04.008

Abstract Study Objective To determine the effect of dexmedetomidine on intraoperative bleeding during septoplasty and tympanoplasty operations. Design Randomized, placebo-controlled study. Setting Univesity medical center. Patients 80 ASA physical status I and II patients, aged 18 to 65 years, 40 of whom were scheduled for septoplasty and 40 to undergo tympanoplasty operations. Interventions Patients undergoing septoplasty (S) and tympanoplasty (T) operations were randomly divided into 4 groups. Dexmedetomidine (D) was administered to Group SD and Group TD first as a bolus dose of one μ g kg−1 , then intraoperative maintenance was supplied with dexmedetomidine 0.7 μ g kg−1 hour−1 . Groups S and T (controls) were given identical amounts of saline. If systolic blood pressure measurements are greater than 20% preoperative values, then fentanyl one μ g kg−1 was given. Measurements Intraoperative blood loss was determined with suction volumes and gauze counting. Bleeding was rated according to a 6-point scale. Hemodynamic parameters and fentanyl administration were recorded. Main Results Group SD had less bleeding and lower bleeding scores ( P < 0.05). In addition, this group received less intraoperative fentanyl ( P < 0.05). The only significant difference between Groups TD and T was the amount of intraoperative fentanyl given (35.4 ± 58.8 vs 110.0 ± 81.0 μ g) ( P < 0.05). Conclusion Dexmedetomidine reduces bleeding, bleeding scores, and intraoperative fentanyl consumption during general anesthesia in septoplasty operations.