Online ISSN: 2515-8260

Keywords : FESS


Comparison between magnesium sulfate and dexmedetomidine in controlled hypotensionduring functional endoscopic sinus surgery

Dr.Sahaja Gunda, Dr.sravanthisuddapally, Dr. GiridharJanampetBekkam, Dr. PakalaSwathi

European Journal of Molecular & Clinical Medicine, 2022, Volume 9, Issue 4, Pages 504-511

Background: Functional endoscopic sinus surgery (FESS) has been recommended as a
treatment option for chronic sinusitis patients who have failed to respond to medical
treatment. In order to maximize the visibility of the operative site during functional
endoscopic sinus surgery (FESS), it is critical to reduce bleeding. The goal of this study was
to examine the effectiveness of dexmedetomidine and magnesium sulphate as hypotensive
agents in FESS in adult patients in order to achieve a bloodless surgical field.
Materials and methods: Sixty patients aged between 18-65 years were randomly assigned into
two groups, the D group for dexmedetomidine (n = 30) the and M group for magnesium
sulfate (n = 30). Patients in the D group received a loading dose of 1 g/kg dexmedetomidine
in 100 mL saline solution 10 minutes before induction and a 0.5–1 g/kg/h infusion via syringe
pump throughout the surgery. Patients in the M group received 40 mg/kg magnesium sulfate
in 100 ml saline solution over 10 min as the intravenous loading dose 10 min before
induction,followed by a 10–15 mg/kg/h infusion.

COMPARATIVE EVALUATION OF THE HYPOTENSIVE EFFECTS OF CLONIDINE TO DEXMEDETOMIDINE DURING FUNCTIONAL ENDOSCOPIC SINUS SURGERY IN THE INDUCTION OF HYPOTENSION: AN INTERVENTIONAL STUDY

Dr Rajveer Basu, Dr Jugvendra Lahari, Kiran Lahari, Dr Preeti Lahari

European Journal of Molecular & Clinical Medicine, 2021, Volume 8, Issue 4, Pages 1941-1947

Background:Decreasing MAP (mean arterial blood pressure) using controlled hypotension, is introduced to improve visibility of the surgical site by reducing blood loss during FESS.
Aims:The present study was conducted to compare and assess the hemodynamic stability and hypotensive efficacy of Clonidine and Dexmedetomidine in FESS.
Materials and Methods:40 subjects were randomly divided into two groups of 20 subjects each. Subjects from Group I received 1 μg/kg dexmedetomidine, whereas, Group II subjects received 2 μg/kg Clonidine. Postoperative complications and Haemodynamic parameters were assessed at baseline, following the loading dose, 1- and 5-minutes following intubation, and every 10 minutes till recovery. These parameters were mean arterial pressure, systolic and diastolic blood pressures, oxygen saturation, and heart rate (HR).
Results:MAP and HR decreased significantly from baseline at all the time intervals of assessment (p<0.001). These values were statistically significant for both intragroup and intergroup for Group I and Group II. Also, statistically non-significant results were seen concerning the visibility of the surgical field. Emergence time was significantly higher for Group I (7.38±0.58 min) than Group II (6.44±0.72 min) with p=0.001. Sedation scores were higher significantly for group I (1.88±1.23) than Group II (1.37±0.12) with p=0.001. VAS scores were significantly lower for Group I (2.24±0.78) than Group II (3.01±0.14) at all time intervals with p=0.001. First rescue analgesia was significantly higher for Group I (110.45±12.25 min) than Group II (84.31±10.06) with the p-value of <0.0001
Conclusion:Present study concludes that, better hemodynamic stability was seen with dexmedetomidine compared to Clonidine. However, decreased blood loss and intraoperative visibility were comparable for both dexmedetomidine and Clonidine. Sedation and prolonged anesthesia were also better with dexmedetomidine.

Determination of complications of Functional Endoscopic Sinus Surgery (FESS)

Dr. Manoj Kumar,Dr. Manish Gulati

European Journal of Molecular & Clinical Medicine, 2018, Volume 5, Issue 1, Pages 277-281

Background:Functional Endoscopic Sinus Surgery (FESS) is the removal of tissue
obstructing the Osteo Metal Complex. The present study was conducted to determine
complications of FESS.
Materials & Methods: 82 adult patients of chronic rhino sinusitis selected for FESS of
both genders were examined with anterior and posterior rhinoscopy. Lanza Kennedy
criteria is used to grade nasal endoscopy findings looking at the presence of secretion,
oedema and polyps. The complications were recorded post operatively.
Results: Age group 15-24 years had 25 males and 18 females, 25-34 years had 12 and 12
females and 35-45 years had 11 males and 4 females. Common complaints was nasal
obstruction in 71, nasal discharge in 15, post nasal drip in 22, headache in 64, halitosis in
10, anosmia & hyposmia in 8 and earache/ ear fullness in 4 patients. Common
complications were synechia seen in 45, lower lid ecchymosis in 12, bleeding nose in 10
and orbital subcutaneous emphysema in 4 patients. The difference was significant (P<
0.05).
Conclusion: Common complications of FESS were synechia, lower lid ecchymosis,
bleeding nose and orbital subcutaneous emphysema.