A Comparison of Dexmedetomidine and Magnesium Sulfate as an Anesthetic Adjuvant in Trans-Sphenoidal Pituitary Surgery

Background: Trans-sphenoidal pituitary surgery is a minimally invasive procedure used for pituitary disorders. Objectives: This study aims to investigate the effects of dexmedetomidine and magnesium sulfate in improving anaesthesia conditions and pain control during trans-sphenoidal pituitary surgery. Methods: This prospective randomised clinical trial included 90 patients between 18 and 65 years of age, with American Society of Anaesthesiologists (ASA) physical status I and II, who were undergoing elective trans-sphenoidal pituitary surgery. Exclusion criteria included a change in surgical technique during surgery and patients who were transferred directly to the ICU with a tracheal tube. Patients were randomly assigned to three groups (group D: Dexmedetomidine, group M: Magnesium sulfate, and group C: Control), and various parameters such as haemodynamics, surgical field evaluation, and pain were assessed. Results: Ninety consecutive patients were included in this study. Forty-seven males (52.2%) and 43 females (47.8%) were evaluated. There were no significant differences among the three groups regarding gender distribution, age, or Body Mass Index (BMI). The mean age of the included patients was 46.27 ± 12.47 years. The measured mean arterial pressure was lower in group D compared to group M (P-value = 0.005). The other variable that statistically differed between the two groups was the numerical rating scale, which was lower in group D (P-value = 0.02). All measured variables in group D and group M were significantly lower compared to the control group, except for the extubation time. Conclusions: Adding dexmedetomidine as an adjuvant anaesthetic medication during trans-sphenoidal pituitary surgery could potentially enhance haemodynamic stability and improve surgeon satisfaction scores.