A comparative study of magnesium sulfate and dexmedetomidine for controlled hypotension during functional endoscopic sinus surgery in the age group of 18–60 years

Background: Intraoperative bleeding during functional endoscopic sinus surgery (FESS) is a major problem that makes the field obscure, thus increasing the operative time, anesthetic challenges, and damage to surrounding structures. We need hypotension-achieving agents that are effective and do not affect blood supply to vital organs. Objective: The objective was to study the efficacy of dexmedetomidine compared to magnesium sulfate for controlling hypotension among adults undergoing FESS. Materials and Methods: A hospital-based prospective study was carried out among 70 adults undergoing FESS. They were divided into two groups of 35 each. Group D received 100 mcg of dexmedetomidine diluted to 50 ml, and Group M received 5 g magnesium sulfate diluted to 50 ml. They were compared for bleeding score, surgeon satisfaction score, Ramsay sedation score, bradycardia, and hypotension. Results: Both the groups were comparable for age, sex, and American Society of Anesthesiologists grade. A higher bleeding score was more common in the magnesium sulfate group compared to the dexmedetomidine group, and the difference was statistically significant. Nineteen surgeons gave a higher score of 4 for expressing their satisfaction for those who received dexmedetomidine compared to only three who gave the same score for the magnesium sulfate group, and the difference was significant. The Ramsay sedation score was same in both the groups. Bradycardia was seen in five cases from the dexmedetomidine group compared to none in the other group, but the difference was not significant. Similarly, hypotension was seen in three cases of dexmedetomidine compared to none in the other group, but the difference was not statistically significant. Conclusion: Dexmedetomidine is better than magnesium sulfate for controlled hypotension among patients aged 18–60 years undergoing functional endoscopic sinus surgery.