Clinical Observation of Dexmedetomidine Used for Local Anesthesia in Endoscopic Sinus Surgery

Objective:To observe the feasibility and effectiveness of local anesthesia assisted with dexmedetomidine for endoscopic sinus surgery. Method:Sixty patients(ASA I or Ⅱ)underwent thyroid adenoma surgery were randomly divided into group D and group S according to random number table method,30 patients in each group. In the group D,the patients were intravenously treated with dexmedetomidine,first with loading dose of 0.5 μg/kg within 10 minutes before the start of surgery,and then with maintaining dose of 0.4 μg/(kg·h),and was stopped 5 minutes before the end of surgery. The group S was treated with the same dose of saline. MAP,HR were recorded of patients entered the operating room(T0),5 minutes before the start of surgery(T1),5 minutes after the start of surgery(T2)and sinus opening hours(T3);collected arterial blood from the dorsalis pedis artery in 3 mL, detected the levels of norepinephrine(NE)and Epinephrine(E)in arterial blood,and visual analogue score(VAS)judgment satisfaction of anesthesia. Result:Compared with the group S,MAP and HR of the groups D were decreased,and NE and E concentrations were significantly lower in T1、T2、T3 three time points,the differences were statistically significant(P0.05). VAS score was significantly higher than that of the group S,the differences were statistically significant(P0.05). Conclusion:Dexmedetomidine can effectively reduce the hemodynamic changes when opening the sinuses caused by stress response,and safe and effective for nasal endoscopic surgery.