Enhanced recovery and early discharge of patients after septoplasty under sedation with dexmedetomidine


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Abstract

Background. Enhanced patient recovery after surgery and discharge on the day of hospitalization allows to avoid the development of a number of adverse events. Currently, there is no consensus on a sedative drug that can provide early discharge after septoplasty. In a clinical study, a comparative analysis of two groups of patients under sedation with dexmedetomidine and propofol was performed. Objective. Assessment of the possibility and determination of the causes of delay of enhanced recovery of patients after septoplasty under sedation with dexmedetomidine or propofol in the settings of multimodal anesthesia. Methods. A randomized, prospective study was conducted. Depending on the sedating medication used, the patients were divided into two groups: the group 1 (n=31) consisted of patients aged 35.09±11.13 years (M±S) treated with septoplasty using propofol; the group 2 (n=30) - patients aged 38.83±11.32 years (M±S) who underwent surgery under sedation with dexmedetomidine. Results. The duration of surgical intervention in the group 1 and group 2 was 58.35±16.43 and 41.13±16.25 minutes (M±S), respectively. In both groups, the time to reach a score of 9-10 with the Aldrete scoring system was 0 minutes. In the group 1, two patients were discharged with a delay, in the group 2, all patients were discharged on the day of surgery. The clinically significant level of pain in the group 1 was the cause of delayed discharge. Conclusion. Sedation with dexmedetomidine in combination with multimodal anesthesia provides for discharge of patients on the day of septoplasty.

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About the authors

Roman E. Leshchenko

Medical Association “New Hospital", Yekaterinburg

Email: ринбург. Россия; e-mal: leshenko.rel@yandex.ru
anesthesiologist-critical care physician

R. E Davydova

Ural State Medical University

References

  1. Jakobsson J.G. Pain management in ambulatory surgery review. Pharmaceuticals (Basel). 2014;7(8):850-65. doi: 10.3390/ph7080850.
  2. Ljungqvist O., Scott M., Fearon K.C. Enhanced Recovery After Surgery: A Review. JAMA. Surg. 2017;152(3):292-98. https://doi.org/10.1001/ iamasurg.uQI2.4954.
  3. Daskaya H, Yazic H., Dogan S., et al. Septoplasty: under general or sedation anesthesia. Which is more efficacious? Eur Arch Otorhinolaryngol. 2014;271(9):2433-36. doi: 10.1007/s00405-013-2865-6.
  4. Dogan R., Erbek S., Gonencer H.H., et al. Comparison of local anaesthesia with dexmedetomidine sedation and general anaesthesia during septoplasty. Eur J Anaesthesiol. 2010;27(11):960-64. Doi: 10.1097/ EJA.0b013e32833a45c4.
  5. Erkul E., Babayigit M., Kuduban O. Comparison of local anesthesia with articaine and lidocaine in septoplasty procedure. Am J Rhinol Allergy 2010;24(5):123-26.
  6. Sarita F.C., Rogerio H., Jorge D.S. Local Anesthesia and Sedation in Otorhinolaryngology Endoscopic Surgery - Functional Endoscopic Sinus Surgery and Tympanoplasty - Routines and Epidemiology in a Reference Center. Am J Anesth Clin Res. 2017;3(1):27-30.
  7. Manpreet S.N., Mandeep Kaur. Comparison of Septoplasty under General Anaesthesia and Monitored Anaesthetic Care with Dexmedetomidine. IOSR. J Dent Med Sci. 2015;14:69-73.
  8. Akca B., Arslan A., Yilbas A.A., et al. Comparison of the effects of patient controlled analgesia (PCA) using dexmedetomidine and propofol during septoplasty operations: a randomized clinical trial. Springerplus. 2016;10(5):572.
  9. Indira K., Udita N. H., Yogendra S., et al. Clonidine as an adauvant in monitored anesthesia care for ENT surgeries: A prospective, randomized, double blind placebo controlled study. Anaesth Pain Intens Care. 2015;19(3):260-68.
  10. Tang C., Huang X., Kang, F, et al. ^^nasal Dexmedetomidine on Stress Hormones, Inflammatory Markers, and Postoperative Analgesia after Functional Endoscopic Sinus Surgery. Mediat Inflamm. 2015:939431. doi: 10.1155/2015/939431.
  11. Paradis J., Rotenberg B.W Open versus endoscopic septoplasty: A single-blinded, randomized, controlled trial. J Otolaryngol Head Neck Surg. 2011;40:24-38.
  12. Practice Guidelines for Moderate Procedural Sedation and Analgesia 2018: A Report by the American Society of Anesthesiologists Task Force on Moderate Procedural Sedation and Analgesia, the American Association of Oral and Maxillofacial Surgeons, American College of Radiology, American Dental Association, American Society of Dentist Anesthesiologists, and Society of Interventional Radiology. Anesthesiol. 2018;128(3): 437-79.
  13. Gerbershagen H.J., Aduckathil A.J., van Wijck L.M., et al. Pain intensity on the first day after surgery: a prospective cohort study comparing 179 surgical procedures. Anesthesiol. 2013;118(4):934-44. doi: 10.1097/ALN.0b013e31828866b3.
  14. Ma'somi A. Comparison of local anesthetic effect of bupivacaine versus bupivacaine plus dexamethasone in nasal surgery. Iran J Otorhinolaryngol. 2013;25(70):7-10.
  15. Kim J.H. The efficacy of reemptive analgesia with pregabalin in septoplasty. Clin Exp Otorhinolaryngol. 2014;7(2):102-5. Doi: https:// doi.org/10.3342/ceo.2014.7.2.102.
  16. Hong C.J., Monteiro E., Lee B.J., et al. Open versus endoscopic septoplasty techniques: A systematic review and meta-analysis. Am J Rhinol Allergy. 2016;30(9)436-42.
  17. He X.Y, Cao J.P, Shi X.Y, et al. Dexmedetomidine versus morphine or fentanyl in the management of children after tonsillectomy and adenoidectomy: A meta-analysis of randomized controlled trials. Ann Otol Rhinol Laryngol. 2013;122: 114-20.
  18. Gan T.J., Diemunsch P, Habib A.S., et al. A. Consensus guidelines for the management of postoperative nausea and vomiting. Anesth Analg. 2014;118(1):85-113. Doi: 10.1213/ ANE.0000000000000002.

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