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Ann Otol Rhinol Laryngol. 2013 Jul;122(7):421-6.

Comparison between dexmedetomidine and remifentanil for controlled hypotension and recovery in endoscopic sinus surgery.

Author information

1
Department of Anesthesiology and Pain Medicine, Catholic University of Korea, Suwon, Korea.

Abstract

OBJECTIVES:

We compared the efficacy of dexmedetomidine and remifentanil hydrochloride in intraoperative field conditions and recovery during endoscopic sinus surgery.

METHODS:

Sixty-six patients (American Society of Anesthesiologists physical status I and II) scheduled for elective endoscopic sinus surgery were enrolled in this prospective, double-blinded, randomized study. The patients were randomly assigned to two groups. Propofol, 2 to 2.5 mg/kg, was administered to both groups to induce anesthesia, which was maintained with desflurane. One group received dexmedetomidine 1 microg/kg over 10 minutes at anesthesia induction, followed by 0.4 to 0.8 microg/kg per hour infusion during maintenance, whereas the other group received remifentanil 1 microg/kg over 1 minute at anesthesia induction, followed by 0.2 to 0.4 microg/kg per minute infusion during maintenance. Surgical conditions, hemodynamic parameters, intraoperative blood loss, time to extubation, sedation, and pain in the postanesthesia care unit (PACU) were recorded.

RESULTS:

There were no significant differences between the two groups with respect to surgical field conditions, blood loss, or extubation time. The sedation score (Modified Observer's Assessment of Alertness/Sedation) in the PACU was significantly lower in the dexmedetomidine group than in the remifentanil group (p < 0.001). No differences were found in total blood loss, surgical field conditions, hemodynamic parameters, time to extubation, or pain in the PACU when the two groups were compared (p > 0.05).

CONCLUSIONS:

Although remifentanil and dexmedetomidine both enabled hypotensive anesthesia and good intraoperative fields for endoscopic sinus surgery, recovery was faster with remifentanil than with dexmedetomidine in the immediate postoperative period.

PMID:
23951692
DOI:
10.1177/000348941312200702
[Indexed for MEDLINE]

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