Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery
Background and objectives: It is crucial to decrease bleeding during functional endoscopic sinus surgery. Our primary goal was to investigate the effects of magnesium sulfate and dexmedetomidine used for controlled hypotension on the visibility of the surgical site. Methods: 60 patients aged between...
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| Format: | Article |
| Language: | English |
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Elsevier
2015-01-01
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| Series: | Brazilian Journal of Anesthesiology |
| Online Access: | http://www.sciencedirect.com/science/article/pii/S0104001414000694 |
| _version_ | 1818024655016951808 |
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| author | Adnan Bayram Ayşe Ülgey Işın Güneş İbrahim Ketenci Ayşe Çapar Aliye Esmaoğlu Adem Boyacı |
| author_facet | Adnan Bayram Ayşe Ülgey Işın Güneş İbrahim Ketenci Ayşe Çapar Aliye Esmaoğlu Adem Boyacı |
| author_sort | Adnan Bayram |
| collection | DOAJ |
| description | Background and objectives: It is crucial to decrease bleeding during functional endoscopic sinus surgery. Our primary goal was to investigate the effects of magnesium sulfate and dexmedetomidine used for controlled hypotension on the visibility of the surgical site. Methods: 60 patients aged between 18 and 65 years were enrolled. In the magnesium sulfate group (Group M), patients were administered 40 mg/kg magnesium sulfate in 100 mL saline solution over 10 min as the intravenous loading dose 10 min before induction, with a subsequent 10–15 μg/kg/h infusion during surgery. In the dexmedetomidine group (Group D), patients were administered 1 μg/kg dexmedetomidine in 100 mL saline solution as the loading dose 10 min before surgery and 0.5–1 μg/kg/h dexmedetomidine during surgery. Deliberate hypotension was defined as a mean arterial pressure of 60–70 mmHg. Results: Bleeding score was significantly decreased in Group D (p = 0.002). Mean arterial pressure values were significantly decreased in Group D compared to that in Group M, except for the initial stage, after induction and 5 min after intubation (p < 0.05). The number of patients who required nitroglycerine was significantly lower in Group D (p = 0.01) and surgeon satisfaction was significantly increased in the same group (p = 0.001). Aldrete recovery score ≥9 duration was significantly shorter in Group D (p = 0.001). There was no difference between the two groups in terms of recovery room verbal numerical rating scale. Conclusions: Dexmedetomidine can provide more effective controlled hypotension and thus contribute to improved visibility of the surgical site. Resumo: Justificativa e objetivos: Diminuir o sangramento durante a cirurgia funcional endoscópica dos seios paranasais é essencial. Nosso objetivo primário foi investigar os efeitos de dexmedetomidina e sulfato de magnésio, usados para o controle da hipotensão, sobre a visibilidade do sítio cirúrgico. Métodos: Foram incluídos no estudo 60 pacientes entre 18 e 65 anos. No grupo sulfato de magnésio (Grupo M), receberam 40 mg de sulfato de magnésio em 100 mL kg−1 de solução salina durante 10 minutos como dose de carga intravenosa 10 minutos antes da indução e infusão subsequente de 10-15 μg kg−1 h−1 durante a cirurgia. No grupo dexmedetomidina (Grupo D), receberam 1 μg kg−1 de dexmedetomidina em 100 mL de solução salina durante 10 minutos como dose de carga 10 minutos antes da cirurgia e 0,5-1 μg kg−1 h−1 de dexmedetomidina durante a cirurgia. Hipotensão controlada foi definida como pressão arterial média de 60-70 mmHg. Resultados: O volume de sangramento diminuiu significativamente no grupo D (p = 0,002). Os valores da pressão arterial média foram significativamente menores no Grupo D, em comparação com o Grupo M, exceto no estágio inicial, pós-indução e cinco minutos pós-intubação (p < 0,05). No Grupo D, o número de pacientes que necessitou de nitroglicerina foi significativamente menor (p = 0,01) e o grau de satisfação do cirurgião foi significativamente maior (p = 0,001). O tempo de recuperação para atingir o escore de Aldrete ≥ 9 foi significativamente menor no grupo D (p = 0,001). Não houve diferença entre os dois grupos em relação aos escores da escala numérica de classificação verbal na sala de recuperação. Conclusões: Dexmedetomidina pode proporcionar um controle mais eficaz da hipotensão e contribuir, assim, para uma melhor visibilidade do sítio cirúrgico. Keywords: Controlled hypotension, Dexmedetomidine, Functional endoscopic sinus surgery, Magnesium sulfate, Palavras-chave: Hipotensão controlada, Dexmedetomidina, Cirugia funcional endoscópica dos seios paranasais, Sulfato de magnésio |
| first_indexed | 2024-12-10T04:03:40Z |
| format | Article |
| id | doaj.art-dc3014b5e81643f98de8d28ba3e96cdb |
| institution | Directory Open Access Journal |
| issn | 0104-0014 |
| language | English |
| last_indexed | 2024-12-10T04:03:40Z |
| publishDate | 2015-01-01 |
| publisher | Elsevier |
| record_format | Article |
| series | Brazilian Journal of Anesthesiology |
| spelling | doaj.art-dc3014b5e81643f98de8d28ba3e96cdb2022-12-22T02:02:55ZengElsevierBrazilian Journal of Anesthesiology0104-00142015-01-016516167Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgeryAdnan Bayram0Ayşe Ülgey1Işın Güneş2İbrahim Ketenci3Ayşe Çapar4Aliye Esmaoğlu5Adem Boyacı6Department of Anesthesiology, Medical Faculty, Erciyes University, Kayseri, Turkey; Corresponding author.Department of Anesthesiology, Medical Faculty, Erciyes University, Kayseri, TurkeyDepartment of Anesthesiology, Medical Faculty, Erciyes University, Kayseri, TurkeyDepartment of Otorhinolaryngology, Medical Faculty, Erciyes University, Kayseri, TurkeyDepartment of Anesthesiology, Medical Faculty, Erciyes University, Kayseri, TurkeyDepartment of Anesthesiology, Medical Faculty, Erciyes University, Kayseri, TurkeyDepartment of Anesthesiology, Medical Faculty, Erciyes University, Kayseri, TurkeyBackground and objectives: It is crucial to decrease bleeding during functional endoscopic sinus surgery. Our primary goal was to investigate the effects of magnesium sulfate and dexmedetomidine used for controlled hypotension on the visibility of the surgical site. Methods: 60 patients aged between 18 and 65 years were enrolled. In the magnesium sulfate group (Group M), patients were administered 40 mg/kg magnesium sulfate in 100 mL saline solution over 10 min as the intravenous loading dose 10 min before induction, with a subsequent 10–15 μg/kg/h infusion during surgery. In the dexmedetomidine group (Group D), patients were administered 1 μg/kg dexmedetomidine in 100 mL saline solution as the loading dose 10 min before surgery and 0.5–1 μg/kg/h dexmedetomidine during surgery. Deliberate hypotension was defined as a mean arterial pressure of 60–70 mmHg. Results: Bleeding score was significantly decreased in Group D (p = 0.002). Mean arterial pressure values were significantly decreased in Group D compared to that in Group M, except for the initial stage, after induction and 5 min after intubation (p < 0.05). The number of patients who required nitroglycerine was significantly lower in Group D (p = 0.01) and surgeon satisfaction was significantly increased in the same group (p = 0.001). Aldrete recovery score ≥9 duration was significantly shorter in Group D (p = 0.001). There was no difference between the two groups in terms of recovery room verbal numerical rating scale. Conclusions: Dexmedetomidine can provide more effective controlled hypotension and thus contribute to improved visibility of the surgical site. Resumo: Justificativa e objetivos: Diminuir o sangramento durante a cirurgia funcional endoscópica dos seios paranasais é essencial. Nosso objetivo primário foi investigar os efeitos de dexmedetomidina e sulfato de magnésio, usados para o controle da hipotensão, sobre a visibilidade do sítio cirúrgico. Métodos: Foram incluídos no estudo 60 pacientes entre 18 e 65 anos. No grupo sulfato de magnésio (Grupo M), receberam 40 mg de sulfato de magnésio em 100 mL kg−1 de solução salina durante 10 minutos como dose de carga intravenosa 10 minutos antes da indução e infusão subsequente de 10-15 μg kg−1 h−1 durante a cirurgia. No grupo dexmedetomidina (Grupo D), receberam 1 μg kg−1 de dexmedetomidina em 100 mL de solução salina durante 10 minutos como dose de carga 10 minutos antes da cirurgia e 0,5-1 μg kg−1 h−1 de dexmedetomidina durante a cirurgia. Hipotensão controlada foi definida como pressão arterial média de 60-70 mmHg. Resultados: O volume de sangramento diminuiu significativamente no grupo D (p = 0,002). Os valores da pressão arterial média foram significativamente menores no Grupo D, em comparação com o Grupo M, exceto no estágio inicial, pós-indução e cinco minutos pós-intubação (p < 0,05). No Grupo D, o número de pacientes que necessitou de nitroglicerina foi significativamente menor (p = 0,01) e o grau de satisfação do cirurgião foi significativamente maior (p = 0,001). O tempo de recuperação para atingir o escore de Aldrete ≥ 9 foi significativamente menor no grupo D (p = 0,001). Não houve diferença entre os dois grupos em relação aos escores da escala numérica de classificação verbal na sala de recuperação. Conclusões: Dexmedetomidina pode proporcionar um controle mais eficaz da hipotensão e contribuir, assim, para uma melhor visibilidade do sítio cirúrgico. Keywords: Controlled hypotension, Dexmedetomidine, Functional endoscopic sinus surgery, Magnesium sulfate, Palavras-chave: Hipotensão controlada, Dexmedetomidina, Cirugia funcional endoscópica dos seios paranasais, Sulfato de magnésiohttp://www.sciencedirect.com/science/article/pii/S0104001414000694 |
| spellingShingle | Adnan Bayram Ayşe Ülgey Işın Güneş İbrahim Ketenci Ayşe Çapar Aliye Esmaoğlu Adem Boyacı Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery Brazilian Journal of Anesthesiology |
| title | Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery |
| title_full | Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery |
| title_fullStr | Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery |
| title_full_unstemmed | Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery |
| title_short | Comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery |
| title_sort | comparison between magnesium sulfate and dexmedetomidine in controlled hypotension during functional endoscopic sinus surgery |
| url | http://www.sciencedirect.com/science/article/pii/S0104001414000694 |
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