Delta Journal of Ophthalmology · Published 2026-04-01 · DOI 10.4103/djo.djo_69_25
Purpose The aim of this study was to evaluate the impact of different hypotensive anesthetic regimens on the surgical field quality, intraoperative bleeding, and postoperative outcome in the patients undergoing dacryocystorhinostomy (DCR). Patients and methods This is a prospective randomized clinical trial that included 90 patients scheduled for DCR. The patients were randomly assigned to receive dexmedetomidine (group D), fentanyl (group F), or magnesium sulfate (group M) as adjuncts to general anesthesia to achieve controlled hypotension. The primary outcome measure was the surgical field quality assessed by a standardized bleeding score by a blinded surgeon, while the secondary outcome measures included the hemodynamic stability, recovery characteristics, postoperative pain scores, analgesic requirements, and perioperative complications. Results All three regimens provided satisfactory surgical field conditions with no statistically significant difference in the bleeding scores (15.2±1.1, 14.3±2.2, and 13.3±5.2) for groups F, D, and M, respectively, (P=0.23). The recovery profiles were generally comparable between the three groups (P>0.05). However, the dexmedetomidine was associated with significantly longer extubation and anesthesia recovery times (P=0.05). The extubating time was 50.3±2.5, 55.3±5.3, and 48.4±4.2 min for groups F, D, and M, respectively, (P=0.73). The orientation time was 8±4.3, 7.3±45, and 6.3±4 min for groups F, D, and M, respectively, (P=0.83). The patients in the dexmedetomidine group demonstrated significantly lower postoperative pain scores, longer time to first analgesic request, and reduced postoperative analgesic consumption compared with the other two groups (P=0.05). The time to the first postoperative analgesic in the dexmedetomidine group was the longest among the three groups (52.37±18.76 min, P=0.05). The incidence of perioperative complications was similar across the three groups. Conclusion Dexmedetomidine, fentanyl, and magnesium sulfate were all effective agents for achieving controlled hypotension and acceptable surgical field quality during DCR. Dexmedetomidine offered superior postoperative analgesia at the expense of prolonged recovery and higher sedation levels. The selection of the hypotensive agent should be individualized based on surgical priorities and postoperative care goals.
Abstract from DOAJ. Public domain (CC0 1.0).
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