Lidocaine and Dexmedetomidine Infusions for Intraoperative Bleeding in Functional Endoscopic Sinus Surgery

A Randomized Double-Blind Trial Comparing Lidocaine and Dexmedetomidine Infusions for Intraoperative Bleeding in Patients Undergoing Functional Endoscopic Sinus Surgery

This work aims to compare lidocaine and dexmedetomidine infusions for intraoperative bleeding in patients undergoing functional endoscopic sinus surgery.

Sinus surgery is one of the most prevalent surgeries on the ear, nose, and throat (ENT). It is mainly carried out through endoscopy and significantly improves the clinical symptoms of patients with rhinosinusitis. Safe conditions must be maintained for this surgery, and the major problem reported during functional endoscopic sinus surgery (FESS) under general anesthesia (GA) is impaired visibility due to excessive bleeding.

Dexmedetomidine is an α2-adrenoceptor agonist with sedative, anxiolytic, sympatholytic, analgesic-sparing effects and minimal depression of respiratory function. It is potent and highly selective for α2-receptors.

Lidocaine is an amino amide-type short-acting local anesthetic (LA). It has a short half-life and a favorable safety profile and is,, therefore,, the LA of choice for continuous IV administration.

Inclusion Criteria:

• Age from 18 to 65 years old.
• American Society of Anesthesiologists (ASA) physical status I - II.
• Scheduled for elective functional endoscopic sinus surgery.

Exclusion Criteria:

• Diabetes mellitus.
• Coagulation disorders.
• Kidney and liver dysfunction.
• Cerebrovascular disease.
• Cardiovascular problems.
• High blood pressure.
• Asthma.
• Chronic obstructive pulmonary disease (COPD).
• End organ damage.
• Psychosis.
• Taking antipsychotic drugs.
• Allergy to study drugs.
• Substance abuse.
• Taking beta blockers.
• Heart rate of < 55 beat/minute.