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Dexmedetomidine Improves the Surgical Field and Postoperative Recovery of Nasal Endoscopic Surgery

Phase 3
Completed
Conditions
Dexmedetomidine
Bleeding
Surgical Field
Interventions
Drug: IV administration of DEX to investigate the effects for functional nasal endoscopic surgery
Drug: IV administration of Midazolam to investigate the effects for functional nasal endoscopic surgery
Registration Number
NCT04276545
Lead Sponsor
Eye & ENT Hospital of Fudan University
Brief Summary

Studies showed dexmedetomidine (DEX) could improve surgical field, but the effect for functional nasal endoscopic surgery (FESS) was unclear. The investigators explored IV administration of a single loading dose DEX (0.5μg/kg) for FESS, and IV administration of midazolam (0.05mg/kg) as a control with comparision of surgical field, haemodynamics, ventilation parameters and recovery.

Detailed Description

The participants received an induction of anesthesia with propofol 2-3 mg/kg, sufentanyl 0.2 μg/kg, and rocuronium 0.6 mg/kg, and then insertion of a flexible laryngeal mask airway was conducted using the index finger insertion technique by anesthesia providers with a minimum of four years endotracheal intubation experience. Mechanical ventilation parameters were as follows: pressure-controlled ventilation mode, ventilation pressure: 12, respiratory rate: 12, oxygen concentration: 50%. The maintenance of general anesthesia was performed with sevoflurane at minimum alveolar concentration of 1.3. After induction, a single loading dose DEX (0.5μg/kg) was IV infusion within 10 minutes, or IV administration of midazolam (0.05mg/kg). Heart rate, blood pressure, tidal volume, ventilation pressure and ETCO2 after insertion of a LMA, 10 minutes, 20 minutes, 30 minutes after drug infusion and transferred to PACU, besides heart rate and blood pressure were recorded before and after induction. Surgical field was evaluated at the time of 10 minutes and 20 minutes after drug infusion. Blood gas analysis was performed just transferred to PACU and before transferred to ward.

Recruitment & Eligibility

Status
COMPLETED
Sex
All
Target Recruitment
118
Inclusion Criteria
  • 120 participants who diagnosed with nasosinusitis
  • The participants need undergo functional nasal endoscopic surgery
  • The participants signed the informed consent
Exclusion Criteria
  • The participants were excluded with any diseases about respiration, circulation, liver and kidney
  • The participants were rejected of the consent

Study & Design

Study Type
INTERVENTIONAL
Study Design
PARALLEL
Arm && Interventions
GroupInterventionDescription
IV administration of dexmedetomidineIV administration of DEX to investigate the effects for functional nasal endoscopic surgeryIV administration of a single loading dose DEX (0.5μg/kg)
IV administration of dexmedetomidineIV administration of Midazolam to investigate the effects for functional nasal endoscopic surgeryIV administration of a single loading dose DEX (0.5μg/kg)
IV administration of midazolamIV administration of DEX to investigate the effects for functional nasal endoscopic surgeryIV administration of midazolam (0.05mg/kg)
IV administration of midazolamIV administration of Midazolam to investigate the effects for functional nasal endoscopic surgeryIV administration of midazolam (0.05mg/kg)
Primary Outcome Measures
NameTimeMethod
Evaluation of surgical field according to the scale reported by Boezaart A.P. in the two groupsThrough study completion, an average of 1 year

Levels of the scale reported by Boezaart A.P. as follows:

0. No bleeding.

1. Slight bleeding - no suctioning of blood required.

2. Slight bleeding - occasional suctioning required. Surgical field not threatened.

3. Slight bleeding - frequent suctioning required. Bleeding threatens surgical field a few seconds after suction is removed.

4. Moderate bleeding - frequent suctioning required. Bleeding threatens surgical field directly after suction is removed.

5. Severe bleeding - constant suctioning required. Bleeding appears faster than can be removed by suction. Surgical field severely threatened and surgery not possible.

Evaluation of surgical field was carried out by Kruskal-Wallis H test.

Secondary Outcome Measures
NameTimeMethod
Comparision of heart rate and mean blood pressure during anesthesia in the two groupsThrough study completion, an average of 1 year

Heart rate (beats/minutes) and mean blood pressure (mmHg) were recorded every 10 minutes, and analyzed with Student's t-test

Comparision of recovery time and blood gas analysis in PACU in the two groupsThrough study completion, an average of 1 year

Recovery time (minutes) included from entering to leaving PACU, and blood gas analysis just before leaving PACU

Trial Locations

Locations (1)

Eye, Ear, Nose and Throat Hospital

🇨🇳

Shanghai, Shanghai, China

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