Effects of a Single Dose Dexmedetomidine on Surgical Field Visibility During Middle Ear Microsurgery: A Randomized Study.

Objectives: To investigate whether a single dose of dexmedetomidine (DEX) improves surgical field visibility. Study Design: Randomized, prospective, double-blind study. Setting: Tertiary teaching hospital. Interventions: ASA I or II patients undergoing tympanoplasty with ossiculoplasty were randomly assigned to receive either 0.8 [mu]g/kg DEX (Group D) or the same volume of saline (Group N) 10 min before anesthesia induction. Main Outcomes: The primary outcome was the visibility of the surgical field rated by surgeons by Boezaart score. The secondary outcomes were consumption of anesthesia, hemodynamic profiles, and subsequent recovery. Results: Boezaart scores for surgical visibility were lower in Group D than in Group N (1.3 +/- 0.8 versus 1.8 +/- 0.9, P = 0.014). Minimum alveolar concentrations of sevoflurane (Group D 1 [0.9/1.1] versus Group N 1 [1/1.2], P = 0.018) and remifentanil consumption (Group D 370 [218/504] [mu]g versus Group N 583 [300/1028] [mu]g, P = 0.002) were less in Group D. Except for a transient increase in blood pressure and a decrease in heart rate during DEX infusion, hemodynamic profiles were more stable in Group D than in Group N. More patients needed morphine rescue and presented with postoperative nausea and vomiting in Group N than in Group D (Group D 1 versus Group N 8, P = 0.029). Recovery time was comparable between the two groups (Group D 19 min versus Group N 18 min, P = 0.569). Conclusion: Use of a single dose of DEX resulted in improved surgical visibility, less consumption of anesthesia, and more favorable hemodynamic profile while not delaying recovery time. Copyright (C) 2016 by Otology & Neurotology, Inc. Image copyright (C) 2010 Wolters Kluwer Health/Anatomical Chart Company

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