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Effect of dexmedetomidine on bleeding during tympanoplasty or septorhinoplasty

Published online by Cambridge University Press:  01 May 2007

M. Durmus ,
A. K. But ,
Z. Dogan ,
A. Yucel ,
M. C. Miman  and
M. O. Ersoy
M. Durmus*
Affiliation:
Inonu University, School of Medicine, Department of *Anaesthesiology, Malatya, Turkey
A. K. But
Affiliation:
Inonu University, School of Medicine, Department of *Anaesthesiology, Malatya, Turkey
Z. Dogan
Affiliation:
Inonu University, School of Medicine, Department of *Anaesthesiology, Malatya, Turkey
A. Yucel
Affiliation:
Inonu University, School of Medicine, Department of *Anaesthesiology, Malatya, Turkey
M. C. Miman
Affiliation:
Inonu University, School of Medicine, Department of Otorhinolaryngology, Malatya, Turkey
M. O. Ersoy
Affiliation:
Inonu University, School of Medicine, Department of *Anaesthesiology, Malatya, Turkey
*
Correspondence to: Mahmut Durmus, Department of Anaesthesiology, School of Medicine, Inonu University, 44069 Malatya, Turkey. E-mail: [email protected]; Tel: +905333468627; Fax: +904223410036
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Summary

Background and objective

The aim of this study was to evaluate the efficacy of dexmedetomidine, an α2-adrenoceptor agonist, on intraoperative bleeding, anaesthetic drug requirement and postoperative pain.

Methods

Forty patients scheduled for elective tympanoplasty and septorhinoplasty operations under general anaesthesia were included in the study. The patients were randomly assigned to receive either a dexmedetomidine 1 μg kg−1 bolus 10 min before induction of anaesthesia plus 0.5 μg kg−1 h−1 infusions during maintenance or placebo. Mean arterial pressure was maintained between 60 and 80 mmHg. Perioperative mean arterial pressure, heart rate, time to extubation and time to awakening were recorded. Bleeding during surgery was assessed by the surgeon, blinded to the study drugs, both intraoperatively and postoperatively as a final personal opinion about the whole surgical process.

Results

The heart rate and mean arterial pressure were significantly lower during induction, operation and extubation in the dexmedetomidine group (P < 0.05). Blood losses were lower in the dexmedetomidine group (P < 0.05). Propofol dose required for induction, and fentanyl and isoflurane consumption were significantly reduced in the dexmedetomidine group (P < 0.05). The total amounts of nitroglycerin and meperidine used were higher in the control group (P < 0.05).

Conclusions

Dexmedetomidine decreased bleeding, postoperative analgesic requirements and intraoperative anaesthetic requirements and was associated with more stable haemodynamic responses to anaesthesia. We conclude that dexmedetomidine is a useful adjuvant to decrease bleeding when a bloodless surgical field is requested.

Keywords

DEXMEDETOMIDINEHYPOTENSION, controlledINTRAOPERATIVE PERIODHAEMORRHAGESURGERY, tympanoplasty, rhinoplasty
Type
Original Article
Information
European Journal of Anaesthesiology , Volume 24 , Issue 5 , May 2007 , pp. 447 - 453
Copyright
Copyright © European Society of Anaesthesiology 2007

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