The use of dexmedetomidine in endoscopic surgical procedures of the nasal cavity in children

Introduction In recent years, dexmedetomidine has come to the forefront in pediatric anesthesiology. In recent years, this drug has begun to be widely used in surgical interventions of the nasal cavity in children. Surgical interventions in the nasal cavity are classified as low-traumatic and low-volume operations, but they are accompanied by fairly intense pain. Dexmedetomidine is widely used in cardiac surgery, neurosurgery, gynecology and dentistry. However, there is not enough experience in using it in otorhinolaryngology. Purpose of the study: Optimization of anesthesia during endoscopic surgical interventions in the nasal cavity in children. Material and Methods In the period from 2022 to 2024, 106 planned endoscopic surgical operations of the nasal cavity were performed in patients aged 10-15 years under local anesthesia and with so-called conscious sedation at the AMU surgical clinic. Patients were randomized into 2 groups: main (n=53) and control (n=53). Patients in the main and control groups underwent septoplasty surgery. Patients in the main group received dexmedetomidine as sedation, and midazolam was used as sedation in the control group. Results In the main group, the average consumption of fentanyl was 50 +/- 20 mcg, while in the control group its consumption was 100 +/- 25 mcg. The consumption of local anesthetic in the main group ranged from 3.0 to 6.0 ml depending on the operation, while in the control group it ranged from 4.0 to 8.0 ml. During intraoperative pain assessment on the BPS-NI pain scale, patients in the main group scored 3-4 points, and in the control group 4-10 points, respectively Conclusion Intraoperative sedation with dexmedetomidine in combination with local anesthesia can be recommended as an alternative to general anesthesia for endoscopic nasal surgery.