Comparative Efficacy of Intravenous Dexmedetomidine and Intravenous Nitroglycerin for Hypotensive Anesthesia in Patients Undergoing Functional Endoscopic Sinus Surgery: A Randomized Double-blind Prospective Study

BACKGROUND: This study was conducted to assess the efficacy of intravenous nitroglycerin versus dexmedetomidine in achieving controlled hypotension in patients with chronic rhinosinusitis during functional endoscopic sinus surgery (FESS), and to compare the effects of these drugs on hemodynamics, intraoperative analgesic requirement, surgical field quality, and recovery characteristics. METHODOLOGY: This randomized study was conducted on 50 patients, randomly assigned into two groups: Group D (dexmedetomidine) and Group N (nitroglycerin). Mean arterial pressure (MAP) was maintained between 50 and 65 mmHg. Intraoperative hemodynamics, fentanyl requirement, extubation time, and surgical field (Boezaart scale) were recorded and statistically analyzed. RESULTS: Group D showed significantly lower mean heart rates (P < 0.001) and reduced fentanyl requirement (P < 0.0001). Group N achieved the target MAP faster and demonstrated shorter extubation times (P < 0.0001). The quality of the surgical field and the duration of the surgery were comparable. CONCLUSIONS: Both the drugs used in our study are effective for controlling hypotension during FESS. Dexmedetomidine offers added analgesic-sparing benefits, while nitroglycerin allows faster recovery, making it preferable in cases requiring early extubation.