“Effect of preoperative dexmedetomidine nebulisation as an adjunct to adrenaline nasal packing on surgical field quality and haemodynamic stability during transsphenoidal resection of pituitary adenoma: A prospective randomised double-blinded clinical study”

Randomised trials for the efficacy of inhalational dexmedetomidine on intraoperative haemodynamic and surgical field quality in patients undergoing transsphenoidal resection of pituitary adenoma are currently very limited. Hence this study has been designed.

Dexmedetomidine has been widely studied in many surgical settings with possible benefits in lowering anaesthetic requirements, improving perioperative haemodynamic stability, and improving postoperative outcomes. This study aims to shed light on its potential as an adjuvant agent in anaesthesia for the specific surgical population and the efficacy of the inhalational route of administration of dexmedetomidine.

Nebulized dexmedetomidine is a well-tolerated alternative to intravenous administration, with promising results in attenuating the haemodynamic stress response during airway manipulation and improving patient comfort. However, there is a paucity of data regarding its impact on surgical field conditions and intraoperative haemodynamics in the context of neurosurgical procedures, especially endonasal transsphenoidal pituitary surgeries where minimal bleeding and stable conditions are critical.

This study is designed to evaluate whether the addition of nebulised dexmedetomidine to standard adrenaline nasal packing enhances surgical field visibility and provide better haemodynamic control, thus offering a potential safer and more effective anaesthetic strategy for this patient population.