Formosan Journal of Surgery (Jan 2018)

Hypotensive effect of labetalol and dexmedetomidine blood loss and surgical conditions in functional endoscopic sinus surgery: A double-blind randomized clinical trial

  • Aliakbar Eghbal,
  • Hesameddin Modir,
  • Esmail Moshiri,
  • Mohammad Khalili,
  • Farzad Zamani Barsari,
  • Abolfazl Mohammadbeigi

DOI
https://doi.org/10.4103/fjs.fjs_131_17
Journal volume & issue
Vol. 51, no. 3
pp. 98 – 104

Abstract

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Background: Excessive bleeding occurs from mucosal edges during functional endoscopic sinus surgery (FESS). This could decrease the visibility of the surgeon and increase the risk incidence of complications. The current study aimed to evaluate the effect of labetalol and dexmedetomidine on intraoperative blood loss and surgical conditions in ESS. Methods: A double-blind randomized clinical trial was conducted on 100 candidates for FESS that randomly were assigned by block randomization method in two groups including labetalol or dexmedetomidine. Heart rate (HR), mean arterial blood pressure, and the percent of arterial oxygen saturation were measured after induction and during the hypotension. These items were recorded till the end of the surgery. A blinded surgeon was assessed the bleeding of operation field. Data were analyzed using t-test, Chi-square, and analysis of variance for repeated measures. Results: The mean time of surgery was not statistically significant between two groups (104.65 ± 7.38 vs. 105.12 ± 7.33). The mean of HR was higher in dexmedetomidine group in all times after induction (P < 0.001) and a significant decreasing trend observed in the mean of HR for labetalol while the HR in dexmedetomidine group was increasing. The extubation and recovery time in dexmedetomidine group was higher than labetalol group (P < 0.001). Moreover, the operation field without bleeding or with low bleeding was higher in labetalol group, and the labetalol could be controlled the bleeding better than the dexmedetomidine. Conclusion: Bleeding score, extubation, and recovery time in labetalol group was lower than dexmedetomidine group. Moreover, patients in labetalol group have had higher recovery score and lower bleeding. Therefore, labetalol could reduce the bleeding during FESS and improved the visualization of the operation field and was superior to dexmedetomidine in concern to lower bleeding and extubation and recovery time.

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