Use of Dexmetomidine in Controlled Hypotension in Dacryocystorhinostomy Surgery: Review Article

Background: Due to its benefits, which include a clean operating field, reduced tissue damage, and no external scarring, endoscopic dacryocystorhinostomy (DCR) has increasingly supplanted the conventional external technique. As a result, the type of anesthetic has evolved. Currently, the majority of patients having DCR are sedated. Nonetheless, it has been discovered that general anesthesia increases the risk of negative side effects, including vomiting, postoperative agitation, and intraoperative and postoperative hemorrhage. This kind of anesthetic is also linked to patients experiencing more severe pain when they wake up after surgery, which can be harmful to them. Finding alternative safe and efficient anesthetic solutions for surgery is still important for those patients who are hesitant to undergo general anesthesia and have substantial risks associated with it. Objective: The purpose of this review paper was to assess how well dexmedetomidine works to provide controlled hypotension following DCR surgery. Methods: We searched PubMed, Google Scholar, and Science Direct for dexmedetomidine, hypotension, dacryocystorhinostomy surgery. The authors also reviewed references in relevant literature, but only the most current or comprehensive study from December 2019 to January 2025 was included. Documents in languages other than English were not considered due to a lack of translation sources. Papers that were not part of important scientific research, such as unpublished manuscripts, oral presentations, and conference abstracts were excluded. Conclusions: In therapeutic use, dexmedetomidine is a common sedative and analgesic medication that lowers stress reaction and doesn't cause respiratory depression. In endoscopic DCR, local anaesthetic (LA) combined with dexmedetomidine as an adjuvant results in more stable hemodynamics and a lower stress reaction during the perioperative phase. Additionally, this anesthesia increases the quality of waking from anesthesia, lowers surgical complications, and produces superior postoperative sedation and analgesic effects.