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Abstract Endoscopic sinus surgery is used for treatment of patients with nasal sinus pathology. Sufficient control of intraoperative bleeding is essential as bleeding reduces the visibility in the operative field. Controlled hypotension is commonly used to achieve a bloodless operative field which is needed for successful endoscopic sinus surgery. Dexmedetomidine is a potent and highly selective α-2 adrenoceptor agonist with sympatholytic, sedative, amnestic, and analgesic properties. With its pharmacological effects as reduction in heart rate and MAP, dexmedetomidine is a novel agent in controlled hypotension. The aim of the study is to test the efficacy of dexmedetomidine with sevoflurane to induce controlled hypotension and get a better surgical field in endoscopic sinus surgery. Sixty adult patients, ASA physical status I or II, scheduled for endoscopic sinus surgery in Sohag University hospital were enrolled in this prospective randomized double blinded controlled study. The patients were assigned randomly into one of two groups, dexmedetomidine group (DG) and fentanyl group (FG). Mean arterial pressure (MAP) was aimed to keep 60±5 mmHg for controlled hypotensive anesthesia. In conclusion, dexmedetomidine with sevoflurane can provide better controlled hypotensive anesthesia and more favourable surgical field during endoscopic sinus surgery. Patients received dexmedetomidine had prolonged recovery time and more sedation scores in early postoperative period. |