Dexmedetomidine versus Esmolol Efficacy for Bloodless Field and Outcome during Functional Endoscopic Sinus Surgery: A Prospective Randomized Trial | ||
| Zagazig University Medical Journal | ||
| Articles in Press, Accepted Manuscript, Available Online from 19 October 2025 | ||
| Document Type: Original Article | ||
| DOI: 10.21608/zumj.2025.420600.4159 | ||
| Authors | ||
| Eslam Elbayoumi* 1; Ashraf Eskandr1; Ayman Rady1; Wafiya mahdy2 | ||
| 1Anesthesiology, Intensive Care and Pain Management, Faculty of Medicine, Menoufia University, Shebin El-Kom, Egypt. | ||
| 2Lecturer of Anesthesiology, Intensive care and Pain management, Faculty of Medicine, Menoufia University, Egypt | ||
| Abstract | ||
| Background: Functional Endoscopic Sinus Surgery (FESS) is commonly performed to treat chronic rhinosinusitis, where a clear, bloodless surgical field is essential for optimal visualization and surgical accuracy. This study aimed to compare Dexmedetomidine and Esmolol in achieving optimal surgical field visibility during FESS as the primary outcome, and to evaluate secondary outcomes, including intraoperative hemodynamics, postoperative sedation, analgesia, and surgeon satisfaction. Methods: Between September 2023 and December 2024, a prospective, triple-blind, randomized trial was conducted at Menoufia University Hospitals. Adult patients (ASA I–II, ages 18–65) scheduled for elective FESS were enrolled. Participants were randomly assigned to receive either dexmedetomidine (Group D) or esmolol (Group E) to maintain surgical field visibility. Intraoperative and postoperative parameters, including hemodynamics, analgesic requirements, recovery scores, time to emergence, and surgical field quality, were recorded and analyzed. Results: Out of 69 screened patients, 52 were enrolled and evenly divided between the two groups. Demographic characteristics, anesthesia duration, and blood loss were comparable. However, Group D exhibited significantly lower heart rates and mean arterial pressures at various intra- and postoperative intervals, indicating superior hemodynamic stability (P < 0.05). Conclusion: Dexmedetomidine proved more effective than esmolol in achieving and maintaining surgical field visibility during FESS. It improved hemodynamic stability, surgeon satisfaction, sedation, and pain management, while slightly prolonging recovery time. Overall, dexmedetomidine offered a smoother and equally safe perioperative profile, supporting its use for enhanced surgical and patient outcomes in FESS. | ||
| Keywords | ||
| Controlled Hypotension; Dexmedetomidine; Esmolol; Functional Endoscopic Sinus Surgery; Hemodynamic Stability | ||
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