Dexmedetomidine as a Component of Anesthetic Management in Otorhinolaryngological Surgery

A.A. Aivardgi, V.N. Kovyrev, V.L. Borodulya, N.V. Bondar, Yu.Yu. Kobeliatskyi

Abstract


The purpose of the present research is seaking for methods of optimization of perioperative analgesia, hemodynamics stabilization, improvement of control over intraoperative hemorrhage in case of septoplasty under the conditions of combined ane­sthesia. 53 patients have been included into the research and they have been divided into 2 groups: a main group (28 people) and a control one (25 people). The main group received infusion of dexmedetomidine — a new agonist of central α2-adrenoreceptors, it started 10 minutes prior to anesthesia induction at a dose of 0.7 μg/kg/h and it was stopped 10 minutes before the completion of the operative intervention. Indices of hemodynamics, general blood test, coagulogram, volume of hemorrhage, duration of anesthesia and operative intervention, doses of anesthetics and analgesics, level of pain by VAS, complications have been studied. There were such stages of the research: 1st — 1st day before anesthesia; 2nd — immediately before the operation (20 minutes); 3rd — du­ring the ane­sthesia (20–30 minutes); 4th — after patient had recovered; 5th — 6 hours after anesthesia; 6th — 12 hours after anesthesia; 7th — on the second day after anesthesia; 8th — on the 3rd day after anesthesia. The use of dexmedetomidine is associated with hemodynamics stabilization during and after anesthesia (р ≤ 0.05), decrease of intraoperative hemorrhage (р ≤ 0.05), improvement of visualization of the operative field and optimization of post-operative analgesia (р ≤ 0.05).


Keywords


dexmedetomidine; septoplasty; hemodynamics; analgesia; hemostasis

References


Vanda G. Yazbek-Karam, Marie M. Aouad Perioperative uses of Dexmedetomidine // M.E.J. ANESTH. — 2008. — Vol. 18(6).

Кобеляцкий Ю.Ю., Ткаченко Р.А., Жовнир В.А. Медикаментозная седация: выбор оптимального препарата. Новая возможность — дексмедетомидин // Medicine Review. — № 3(21).

Durmus M., But A.K., Dogan Z., Yucel A., Miman M.C., Ersoy M.O. Effect of dexmedetomidine on bleeding during tympanoplasty or septorhinoplasty // Eur. J. Anaesthesiol. — 2007 May. — Vol. 24(5). — P. 447-53. — Epub. 2007 Jan 23.

Ayoglu H., Yapakci O., Ugur M.B., Uzun L., Altunkaya H., Ozer Y., Uyanik R., Cinar F., Ozkocak I. Effectiveness of dexmedetomidine in reducing bleeding during septoplasty and tympanoplasty operations // J. Clin. Anesth. — 2008 Sep. — Vol. 20(6). — P. 437-41. — Doi: 10.1016/j.jclinane.2008.04.008.

Paris A., Tonner P.H. Dexmedetomidine in anaesthesia // Curr. Opin. Anaesthesiol. — 2005 Aug. — Vol. 18(4). — P. 412-8.

Tanskanen P.E., Kyttä J.V., Randell T.T., Aantaa R.E. Dexmedetomidine as an anaesthetic adjuvant in patients undergoing intracranial tumour surgery: a double-blind, randomized and placebo-controlled study // Br. J. Anaesth. — 2006 Nov. — Vol. 97(5). — P. 658-65. — Epub. 2006 Aug 16.

Ohtani N., Yasui Y., Watanabe D., Kitamura M., Shoji K., Masaki E. Perioperative infusion of dexmedetomidine at a high dose reduces postoperative analgesic requirements: a randomized control trial // J. Anesth. — 2011 Dec. — Vol. 25(6). — P. 872-8. — Doi: 10.1007/s00540-011-1239-8. Epub 2011 Sep 28.

Rodriguez Valiente A., Roldan Fidalgo A., Laguna Ortega D. Bleeding control in endoscopic sinus surgery: a systematic review of the literature // Rhinology. — 2013 Dec. — Vol. 51(4). — P. 298-305. — Doi: 10.4193/Rhin12.048.

Ke J., Pen X. The effect of dexmedetomidine on post-operative blood pressure after controlled hypotension in endoscopic sinus surgery // Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. — 2013 May. — Vol. 27(10). — P. 478-80.




DOI: https://doi.org/10.22141/2224-0586.8.63.2014.84191

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