European Archives of Oto-Rhino-Laryngology

, Volume 274, Issue 1, pp 239–245 | Cite as

Surgical conditions during FESS; comparison of dexmedetomidine and remifentanil

  • Safinaz KarabayirliEmail author
  • Kadriye Serife Ugur
  • Ruveyda Irem Demircioglu
  • Bunyamin Muslu
  • Burhanettin Usta
  • Huseyin Sert
  • Nebil Ark


To compare dexmedetomidine with remifentanil in functional endoscopic sinus surgery (FESS) in regards to intra-operative bleeding, anesthetic consumption and post-operative recovery. Randomized, double blind study. Tertiary care medical center. Fifty patients with nasal polyposis who had been scheduled for FESS were randomly divided into two groups. In group D (n = 25), dexmedetomidine 1 µg/kg infused intravenous (IV) over 10 min before anesthesia induction, followed by a continuous of 0.7 µg/kg/h infusion during operation. In group R (n = 25), 1 µg/kg remifentanil IV bolus, was administered with induction of anesthesia and continued 0.25–0.50 µg/kg/min during operation. Heart rates, mean arterial pressure, end tidal CO2, end tidal sevoflurane were recorded. The amount of bleeding, surgical field condition for bleeding and the time to reach Aldrete recovery score 9–10 were recorded. Postoperative nausea, vomiting, pain, shivering, sedation were followed up over 24 h. There was no significant difference between groups according to the amount of bleeding during surgery, assessment of surgical field condition, consumption of sevoflurane, scores of postoperative VAS, rates of nausea and vomiting, shivering, demands of additional analgesic medication (P > 0.05). The time to reach Aldrete recovery score 9–10, sedation scores at the postoperative first hour were significantly higher in group D (P = 0.001). We concluded that in comparison to remifentanil, dexmedetomidine during FESS for controlled hypotension is of limited value as it has no additional benefits in terms of control of hypotension and amount of bleeding in the surgical field and it is associated with higher recovery time and first-hour postoperative sedation scores.


Dexmedetomidine Remifentanil Functional endoscopic sinus surgery Controlled hypotension 


Compliance of ethical standards

Conflict of interest

All authors declared no conflicts of interest. There was not any financial support.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


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Copyright information

© Springer-Verlag Berlin Heidelberg 2016

Authors and Affiliations

  • Safinaz Karabayirli
    • 1
    Email author
  • Kadriye Serife Ugur
    • 2
  • Ruveyda Irem Demircioglu
    • 1
  • Bunyamin Muslu
    • 1
  • Burhanettin Usta
    • 1
  • Huseyin Sert
    • 1
  • Nebil Ark
    • 2
  1. 1.Department of Anesthesiology and Reanimation, Faculty of MedicineTurgut Ozal UniversityEmek, AnkaraTurkey
  2. 2.Department of Otolaryngology and Head and Neck Surgery, Faculty of MedicineTurgut Ozal UniversityAnkaraTurkey

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