Dexmedetomidine Nasal Packing Versus Intravenous Dexmedetomidine for Controlling Bleeding During Turbinate Surgeries: A Randomized Double-Blind Trial

Background: Nasal obstruction due to hypertrophied turbinates (HT) is one of the common reasons for patients undergoing turbinate operations. This condition is associated with intraoperative nasal bleeding, which can obscure visibility of the field and prolong surgery time. Objectives: The purpose of this study is to compare dexmedetomidine-soaked nasal packing (NP) and intravenous (IV) dexmedetomidine (DEX) for managing bleeding during turbinate surgeries to reduce blood loss and improve surgical field quality. Methods: This randomized, double-blind trial was conducted on 60 patients aged between 18 and 65 years undergoing turbinate surgeries. Patients were randomly assigned into two equal groups: Group NP received DEX-soaked NP (1.5 µg/kg for 10 minutes) and an IV saline bolus followed by saline infusion. Group IV received a 0.5 µg/kg DEX bolus over 10 minutes, followed by a 0.1 - 0.4 µg/kg per hour IV infusion and saline-soaked NP. Results: The mean intraoperative blood loss was 124.1 ± 34.85 mL in group NP and 115.63 ± 31.89 mL in group IV, with no significant difference. Intraoperative hemodynamics, surgical field quality scores, time to first rescue analgesia, total postoperative pethidine consumption, pain score, patient satisfaction, and side effects were comparable. Conclusions: Dexmedetomidine NP is non-inferior to IV DEX for controlling intraoperative bleeding during turbinate surgery. Both methods provided comparable surgical field quality, patient satisfaction, and pain management outcomes.