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Intranasal Dexmedetomidine on Stress Hormones, Inflammatory Markers, and Postoperative Analgesia after Functional Endoscopic Sinus Surgery.

Tang C, Huang X, Kang F, Chai X, Wang S, Yin G, Wang H, Li J - Mediators Inflamm. (2015)

Bottom Line: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome.Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05).Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.

ABSTRACT

Background: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome. This study evaluated the effect of intranasally administered dexmedetomidine (DEX) in combination with local anesthesia (LA) on the relief of stress and the inflammatory response during functional endoscopic sinus surgery (FESS).

Methods: Sixty patients undergoing FESS were randomly allocated to receive either intranasal DEX (DEX group) or intranasal saline (Placebo group) 1 h before surgery. Stress hormones, inflammatory markers, postoperative pain relief, hemodynamic variables, blood loss, surgical field quality, body movements, and satisfaction were assessed.

Results: Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05). The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001). Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

Conclusions: Patients receiving intranasal DEX with LA for FESS exhibited less perioperative stress and inflammatory response as well as better postoperative comfort with hemostatic stuffing and analgesia.

No MeSH data available.


Related in: MedlinePlus

Hemodynamic variables of patients receiving intranasal DEX and placebo at each recording time point. Values are given as Mean ± SD. ∗P < 0.05; ∗∗P < 0.0001. Baseline (T0), 5, 30 min after intranasal instillation (T1, 2), before local anesthesia (T3), the beginning of the operation (T4), 30 min after operation (T5), the end of operation (T6), and out of PACU (T7). Between-group comparison of hemodynamic variables at the same time period after intranasal drugs (from T3 to T7); DEX group was lower compared to Placebo group (P < 0.05, P < 0.0001, resp.).
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fig5: Hemodynamic variables of patients receiving intranasal DEX and placebo at each recording time point. Values are given as Mean ± SD. ∗P < 0.05; ∗∗P < 0.0001. Baseline (T0), 5, 30 min after intranasal instillation (T1, 2), before local anesthesia (T3), the beginning of the operation (T4), 30 min after operation (T5), the end of operation (T6), and out of PACU (T7). Between-group comparison of hemodynamic variables at the same time period after intranasal drugs (from T3 to T7); DEX group was lower compared to Placebo group (P < 0.05, P < 0.0001, resp.).

Mentions: There was no difference about SAP, DBP, HR, and Rate Pressure Product (RPP) at baseline between the two groups, and they both had a rise over time during the operation (from T3 to T6). However, the difference about HR and RPP was significant in Placebo group (P < 0.0001). Between-group comparison of hemodynamic variables at the same time period after intranasal drugs (from T3 to T7) and DEX group was lower compared to Placebo group (at P < 0.05 and P < 0.0001, resp.) (Figure 5).


Intranasal Dexmedetomidine on Stress Hormones, Inflammatory Markers, and Postoperative Analgesia after Functional Endoscopic Sinus Surgery.

Tang C, Huang X, Kang F, Chai X, Wang S, Yin G, Wang H, Li J - Mediators Inflamm. (2015)

Hemodynamic variables of patients receiving intranasal DEX and placebo at each recording time point. Values are given as Mean ± SD. ∗P < 0.05; ∗∗P < 0.0001. Baseline (T0), 5, 30 min after intranasal instillation (T1, 2), before local anesthesia (T3), the beginning of the operation (T4), 30 min after operation (T5), the end of operation (T6), and out of PACU (T7). Between-group comparison of hemodynamic variables at the same time period after intranasal drugs (from T3 to T7); DEX group was lower compared to Placebo group (P < 0.05, P < 0.0001, resp.).
© Copyright Policy - open-access
Related In: Results  -  Collection

Show All Figures
getmorefigures.php?uid=PMC4496499&req=5

fig5: Hemodynamic variables of patients receiving intranasal DEX and placebo at each recording time point. Values are given as Mean ± SD. ∗P < 0.05; ∗∗P < 0.0001. Baseline (T0), 5, 30 min after intranasal instillation (T1, 2), before local anesthesia (T3), the beginning of the operation (T4), 30 min after operation (T5), the end of operation (T6), and out of PACU (T7). Between-group comparison of hemodynamic variables at the same time period after intranasal drugs (from T3 to T7); DEX group was lower compared to Placebo group (P < 0.05, P < 0.0001, resp.).
Mentions: There was no difference about SAP, DBP, HR, and Rate Pressure Product (RPP) at baseline between the two groups, and they both had a rise over time during the operation (from T3 to T6). However, the difference about HR and RPP was significant in Placebo group (P < 0.0001). Between-group comparison of hemodynamic variables at the same time period after intranasal drugs (from T3 to T7) and DEX group was lower compared to Placebo group (at P < 0.05 and P < 0.0001, resp.) (Figure 5).

Bottom Line: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome.Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05).Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

View Article: PubMed Central - PubMed

Affiliation: Department of Anesthesiology, Anhui Provincial Hospital, Anhui Medical University, Hefei, China.

ABSTRACT

Background: A strong ongoing intraoperative stress response can cause serious adverse reactions and affect the postoperative outcome. This study evaluated the effect of intranasally administered dexmedetomidine (DEX) in combination with local anesthesia (LA) on the relief of stress and the inflammatory response during functional endoscopic sinus surgery (FESS).

Methods: Sixty patients undergoing FESS were randomly allocated to receive either intranasal DEX (DEX group) or intranasal saline (Placebo group) 1 h before surgery. Stress hormones, inflammatory markers, postoperative pain relief, hemodynamic variables, blood loss, surgical field quality, body movements, and satisfaction were assessed.

Results: Plasma epinephrine, norepinephrine, and blood glucose levels were significantly lower in DEX group as were the plasma IL-6 and TNF-α levels (P < 0.05). The weighted areas under the curve (AUCw) of the VAS scores were also significantly lower in DEX group at 2-12 h after surgery (P < 0.001). Furthermore, hemodynamic variables, blood loss, body movements, discomfort with hemostatic stuffing, surgical field quality, and satisfaction scores of patients and surgeons were significantly better (P < 0.05) in DEX group.

Conclusions: Patients receiving intranasal DEX with LA for FESS exhibited less perioperative stress and inflammatory response as well as better postoperative comfort with hemostatic stuffing and analgesia.

No MeSH data available.


Related in: MedlinePlus