xRead - Nasal Obstruction (September 2024) Full Articles

20426984, 2021, 3, Downloaded from https://onlinelibrary.wiley.com/doi/10.1002/alr.22741 by Stanford University, Wiley Online Library on [01/07/2024]. See the Terms and Conditions (https://onlinelibrary.wiley.com/terms-and-conditions) on Wiley Online Library for rules of use; OA articles are governed by the applicable Creative Commons License

555

Orlandi et al.

(Continues)

Compared with remifentanil, DEX during ESS showed limited hemodynamic benefits, but it is associated with faster recovery.

There was no difference in the operative field, or post-operative pain scores for remifentanil and DEX in ESS.

Using DEX resulted in improved intraoperative bleeding, hemodynamic stability and postoperative VAS scores.

Both remifentanil and DEX provided similar surgical field visualization, hemodynamic stability, and post-operative pain scores.

Premedication with clonidine provided more favorable hemodynamic parameters and better pain control compared to midazolam.

Intranasal DEX with local anesthesia used in ESS resulted in decreased perioperative stress and inflammatory response improved analgesia, and better hemodynamic variables as well as satisfaction scores.

Both DEX and midazolam provided adequate analgesia and sedation in those undergoing nasal surgeries, with higher amounts of rescue tramadol used in the midazolam group

Study Year LOE Design Study Groups Clinical Endpoint Conclusions Alpha 2 –Agonists

Postoperative VAS at 30 minutes and 24 hours Side effects

Pre-operative anxiety/ sedation

Postoperative VAS at 2, 4, 8, 12, 24, and 48 hours Hemodynamics Stress hormones

Postoperative VAS

Surgical field/ bleeding Adverse effects

Rescue analgesia demand Sedation score

Surgical field conditions

Hemodynamic parameters Sedation score Pain in PACU

Hemodynamics

Surgical field visualization

Hemodynamic parameters Postoperative VAS

Anesthetic requirement Hemodynamic profile

Postoperative VAS

Inflammatory marker levels

Postoperative VRS

Consumption of tramadol

Patient satisfaction scores Adverse Events

Dexmedetomidine IV (25) Remifentanil IV (25)

Dexmedetomidine IV (32) Remifentanil IV (34)

Dexmedetomidine IV (20) Saline solution IV (20)

Dexmedetomidine IV (18) Remifentanil IV (21) Clonidine IV (20)

Midazolam IV (20)

Dexmedetomidine nasal (30) Placebo nasal drops (30)

Dexmedetomidine IV (35) Midazolam IV (35)

Wawrzyniak 1900 2014 3 e Prospective DB RCT

Karabayirli 1896 2017 2 Prospective, DB RCT

Lee 1897 2013 2 Prospective, DB RCT

Guven 1875 2011 2 Prospective, DB RCT

Kim 1899 2015 3 Prospective, Cohort Study

Tang 1860 2015 2 Prospective, DB RCT

Karaaslan 1898 2007 2 Prospective, DB RCT

TABLE XII-4 (Continued)