Clinical application of dexmedetomidine combined with dezocine in local anesthesia for endoscopic dacryocystorhinostomy

• Published in: Ear, nose, & throat journal Vol. 104; no. 4; pp. NP210 - NP215
• Main Authors: Zhao, Lu, Sun, Zuojun, Shen, Wenting, Zeng, Yongheng
• Format: Journal Article
• Language: English
• Published: Los Angeles, CA SAGE Publications 01.04.2025; SAGE PUBLICATIONS, INC
• Subjects: Adult; Anesthesia, General - methods; Anesthesia, Local - methods; Bridged Bicyclo Compounds, Heterocyclic - administration & dosage; Dacryocystorhinostomy - methods; Dexmedetomidine - administration & dosage; Endoscopy; Endoscopy - methods; Female; General anesthesia; Heart Rate - drug effects; Humans; Local anesthesia; Male; Middle Aged; Pain Measurement; Pain, Postoperative - prevention & control; Surgery; Tetrahydronaphthalenes - administration & dosage; endoscopic dacryocystorhinostomy; local anesthesia; general anesthesia; Dexmedetomidine; dezocine
• ISSN: 0145-5613; 1942-7522; 1942-7522
• DOI: 10.1177/01455613221108366

Objective To investigate the clinical effect of dexmedetomidine combined with dezocine in local anesthesia for endoscopic dacryocystorhinostomy (DCR). Methods Ninety patients undergoing elective endoscopic DCR were randomly divided into two groups, local anesthesia group (LA group n = 45) and general anesthesia group (GA group, n = 45). These subjects were all American Society of Anesthesiologists (ASA)-Physical Status I-II patients. The changes of mean arterial pressure (MAP) and heart rate (HR) were observed and recorded before anesthesia (T0), after anesthesia (T1), at the beginning of surgery (T2), and at the end of surgery (T3). The visual analogue scale (VAS) score was observed and recorded immediately after awakening from anesthesia and at 1, 2, 6, and 12 h after surgery. Additionally, the occurrence of adverse reactions after surgery and the sedation-agitation scale (SAS) score after awakening were recorded. Results Compared with the LA group, the MAP and HR of the GA group were significantly lower at T1 and T2, but significantly higher at T3. Local anesthesia was associated with lower VAS score immediately after awakening and at 1, 2, 6, and 12 h after surgery. Also, local anesthesia caused a lower incidence of postoperative agitation, nausea, and vomiting. The SAS score in the LA group was markedly higher than that in the GA group. Conclusion Local anesthesia with dexmedetomidine and dezocine as adjuvants in endoscopic DCR has more stable hemodynamics and reduces the stress response during perioperative period. Also, this anesthesia achieves better postoperative sedation and analgesia effects, reduces postoperative complications, and improves the quality of awakening from anesthesia. Collectively, local anesthesia is a comfortable and safe option for patients with high risks of general anesthesia and those unwilling to receive general anesthesia.