A COMPARISON OF THE EFFECTS OF MAGNESIUM SULPHATE AND DEXMEDETOMIDINE ON SURGICAL VISION QUALITY IN ENDOSCOPIC SINUS SURGERY
A.AKKAYA
1, UY.TEKELİOĞLU
1, A.DEMİRHAN
1, M.BİLGİ
1, İ.YILDIZ
1, H.KOÇOĞLU
1, AD.KURT
1, T.APUHAN
2
DEPARTMENT OF ANESTHESIOLOGY AND REANIMATION, ABANT IZZET BAYSAL UNIVERSITY MEDICAL SCHOOL, BOLU, TURKEY 1
DEPARTMENT OF HEAD AND NECK SURGERY, ABANT IZZET BAYSAL UNIVERSITY MEDICAL SCHOOL, BOLU, TURKEY 2
Even a small amount of bleeding during
endoscopic sinus surgery (ESS) can corrupt the endoscopic field and complicate
the procedure. Various techniques, including induced hypotension, can minimize
bleeding during ESS.
We compared the surgical vision quality,
hemodynamic parameters, postoperative pain, and other effects of magnesium, a
hypotensive agent, and of dexmedetomidine, which was initially developed for
short-term sedation in the intensive care unit but also is an alpha 2 agonist
sedative.
Sixty patients between the ages of 18-45 were
divided into either the magnesium group (Group M) or the dexmedetomidine group
(Group D). In Group M, magnesium sulphate was given with a pre-induction
loading dose of 50 mg/kg over 10 minutes and maintained at 15
mg/kg/hour; in Group D, dexmedetomidine was given at 1 mcg/kg 10 minutes before
induction and maintained at 0.6 mcg/kg/hour. Intraoperatively, the hemodynamic
and respiratory parameters and 6-point intraoperative surgical field evaluation
scale (IOSFE) were recorded. During the postoperative period, an 11-point
numerical pain scale, the Ramsey sedation scale, the nausea/vomiting scale, the
adverse effects profile, and itching parameters were noted.
Group D showed a significant decrease in IOSFE
scale score and heart rate. The average operation time was 50 minutes, and
Group M had a higher number of prolonged surgeries. No significant difference
was found in the other parameters.
Due to its reduction of bleeding and heart rate in
ESS and its positive impacts on the duration of surgery, we consider
dexmedetomidine to be a good alternative to magnesium.
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