Keywords : Massive Hemorrhage
A Randomized Controlled trial to compare Nitroglycerine with Dexmedetomidine for Controlled Hypotension during Endoscopic resection of Juvenile Nasopharyngeal Angiofibroma
European Journal of Molecular & Clinical Medicine,
2022, Volume 9, Issue 3, Pages 5340-5348
Background:Juvenile nasopharyngeal angiofibroma(JNA) is a locally invasive benign vascular tumor. Controlled hypotension is used to facilitate endoscopic resection to reduce the blood loss and stabilize the hemodynamics. Various agents are tried till now to achieve the goal.
Objective: To compare the effectiveness of Nitroglycerine withDexmedetomidine in terms of hemodynamics and blood loss during Endoscopic resection of Juvenile Nasopharyngeal Angiofibroma
Methods: Ethics Committee has approved this Randomized Controlled trial which was conducted among 40 patients randomly divided into two groups by simple randomization using computer generated random numbers.Informed consent was taken from all the eligible participants. Group D(n=20) receivedDexmedetomidine 1µg/kg over 15 min followed by a maintenance infusion at 0.5µg/kg/hourand GroupN (n=20)received (n=20), Nitroglycerine 0.5µg/kg/min and titrated in doses 0.5-5µg/kg/min for target blood pressure respectively. Standard guidelines were followed throughout the study protocol for data collection. Data was analyzed using mean and standard deviation in two groups.
Results:Both the groups were comparable for baseline parameters. There is statistically significant difference in mean pulse rate between two groups Group D: 66.09±2.83, Group N: 86.59±4.24 (p=0.0001). Blood loss was lower in Group D: 310.71±140.58 compared to Group N: 482.61±141.42, and is statistically significant (p=0.0004). SBP,DBPand MAP were lower in Group D throughout the surgery.
Conclusions:Dexmedetomidine is a better hypotensive agent with favorablehemodynamics and less blood loss when compared to Nitroglycerine. Hence we recommend use of Dexmedetomidine over nitroglycerine in patients during Endoscopic resection of Juvenile Nasopharyngeal Angiofibroma.