Controlled hypotension in endoscopic sinus surgery with dexmedetomidine as adjunct: A report of two cases

摘要

The success of endoscopic surgery in otolaryngology largely depends on the surgical field, where the presence of significant bleeding is a critical factor. Bleeding obscures surgical planes and the recognition of anatomical landmarks becomes quite difficult. Various manoeuvers and drugs have been used for optimization of the surgical field. Conventionally, beta blockers and sodium nitroprusside have been used to control the intraoperative blood pressure. Newer agents such as remifentanil and adrenergic alpha-2 agonists such as clonidine and dexmedetomidine are also being tried. We report two cases of endoscopic sinus surgery (ESS) where dexmedetomidine infusion as adjunct to propofol infusion and inhalational anesthesia with sevoflurane [minimum alveolar concentration (MAC) 0.5-0.8] were utilized for providing an optimal surgical field.