A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery
Abstract Introduction Transnasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soa...
| Main Authors: | , , |
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| Format: | Article |
| Language: | English |
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Thieme Medical Publishers, Inc.
2017-10-01
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| Series: | Indian Journal of Neurosurgery |
| Subjects: | |
| Online Access: | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606342 |
| _version_ | 1818119690768089088 |
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| author | Ajay Prasad Hrishi Karen Ruby Lionel Prakash Nair |
| author_facet | Ajay Prasad Hrishi Karen Ruby Lionel Prakash Nair |
| author_sort | Ajay Prasad Hrishi |
| collection | DOAJ |
| description | Abstract
Introduction Transnasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soaked nasal packing and the intense noxious stimulus during the surgery.
Aims To evaluate the effect of dexmedetomidine for preoperative nasal passage preparation on the surgical field visualization and hemodynamic profile of patients during TNTS surgery.
Material and Methods Cotton strips soaked in dexmedetomidine were used for nasal preparation. The primary outcomes studied were the quality of surgical field visualization through the endoscope and the amount of bleeding that occurred while raising the nasal mucosal flap. The secondary outcomes assessed were the intraoperative anesthetic and analgesic requirement and the hemodynamic profile.
Statistical Analysis Data from the study were summarized as mean and SD. Associations were tested using chi-square test for nonparametric data and for continuous variables ANOVA for repeated measures. A p-value < 0.05 was considered as statistically significant and < 0.01 as highly significant. SPSS 17.0 was used for analysis.
Results Seventeen (85%) patients had a Formmer's score of 1, which was an excellent surgical field quality. Two (10%) patients had a Formmer's score of 2, and one (5%) had a Formmer's score of 3. There were no statistically significant variations in heart rate and blood pressure with reduced anesthetic requirement.
Conclusion Intranasal dexmedetomidine provides good surgical field conditions with the added advantage of lesser hemodynamic fluctuations. |
| first_indexed | 2024-12-11T05:14:13Z |
| format | Article |
| id | doaj.art-986026d699c34dfdb69c8220a2618926 |
| institution | Directory Open Access Journal |
| issn | 2277-954X 2277-9167 |
| language | English |
| last_indexed | 2024-12-11T05:14:13Z |
| publishDate | 2017-10-01 |
| publisher | Thieme Medical Publishers, Inc. |
| record_format | Article |
| series | Indian Journal of Neurosurgery |
| spelling | doaj.art-986026d699c34dfdb69c8220a26189262022-12-22T01:19:51ZengThieme Medical Publishers, Inc.Indian Journal of Neurosurgery2277-954X2277-91672017-10-01060317017510.1055/s-0037-1606342A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base NeurosurgeryAjay Prasad Hrishi0Karen Ruby Lionel1Prakash Nair2Division of Neuroanesthesia, Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, IndiaDivision of Neuroanesthesia, Department of Anesthesiology, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, IndiaDepartment of Neurosurgery, Sree Chitra Tirunal Institute for Medical Sciences and Technology, Trivandrum, Kerala, IndiaAbstract Introduction Transnasal transsphenoidal (TNTS) approach is preferred for surgical excision of the pituitary gland. Despite its numerous merits, the TNTS approach creates wide fluctuations in hemodynamic parameters that are attributed to the routine application of adrenaline-soaked nasal packing and the intense noxious stimulus during the surgery. Aims To evaluate the effect of dexmedetomidine for preoperative nasal passage preparation on the surgical field visualization and hemodynamic profile of patients during TNTS surgery. Material and Methods Cotton strips soaked in dexmedetomidine were used for nasal preparation. The primary outcomes studied were the quality of surgical field visualization through the endoscope and the amount of bleeding that occurred while raising the nasal mucosal flap. The secondary outcomes assessed were the intraoperative anesthetic and analgesic requirement and the hemodynamic profile. Statistical Analysis Data from the study were summarized as mean and SD. Associations were tested using chi-square test for nonparametric data and for continuous variables ANOVA for repeated measures. A p-value < 0.05 was considered as statistically significant and < 0.01 as highly significant. SPSS 17.0 was used for analysis. Results Seventeen (85%) patients had a Formmer's score of 1, which was an excellent surgical field quality. Two (10%) patients had a Formmer's score of 2, and one (5%) had a Formmer's score of 3. There were no statistically significant variations in heart rate and blood pressure with reduced anesthetic requirement. Conclusion Intranasal dexmedetomidine provides good surgical field conditions with the added advantage of lesser hemodynamic fluctuations.http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606342intranasal dexmedetomidinetransnasal trans-sphenoidalskull base neurosurgery |
| spellingShingle | Ajay Prasad Hrishi Karen Ruby Lionel Prakash Nair A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery Indian Journal of Neurosurgery intranasal dexmedetomidine transnasal trans-sphenoidal skull base neurosurgery |
| title | A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery |
| title_full | A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery |
| title_fullStr | A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery |
| title_full_unstemmed | A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery |
| title_short | A Novel Use of a Novel Drug: Preoperative Nasal Preparation with Dexmedetomidine for Transnasal Transsphenoidal Neurosurgery Approach in Skull Base Neurosurgery |
| title_sort | novel use of a novel drug preoperative nasal preparation with dexmedetomidine for transnasal transsphenoidal neurosurgery approach in skull base neurosurgery |
| topic | intranasal dexmedetomidine transnasal trans-sphenoidal skull base neurosurgery |
| url | http://www.thieme-connect.de/DOI/DOI?10.1055/s-0037-1606342 |
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