Dexmedetomidine can reduce cognitive disorders after FESS; a quasi-experimental, randomized trial
Abstract
Background & objective: Functional endoscopic sinus surgery (FESS) needs a clear surgical field, which can be improved with controlled hypotension. This technique helps reduce bleeding during the procedure. However, hypotension may increase the risk of postoperative cognitive impairment. Dexmedetomidine is an α2-agonist that provides sedation, analgesia, and neuroprotection without affecting respiration. This study aims to evaluate the effect of dexmedetomidine on cognitive function after surgery.
Methods: A quasi-experimental study with a randomized pre-test–post-test design was conducted in patients undergoing FESS at RSUP Dr. Kariadi, Semarang. Subjects were divided into two groups, namely the dexmedetomidine and remifentanil groups. Cognitive function was assessed by MMSE examination, and S100B levels were measured before and within 24 hours after surgery. P < 0.05 was considered significant.
Results: A total of 28 patients were included in this study, with similar characteristics between the two groups. Pre- and postoperative Mini-Mental State Examination (MMSE) scores were found to be no different in the dexmedetomidine group (28.76 ± 5.02 vs 29.07 ± 1.84; P > 0.05), in the remifentanil group there was a significant difference (30.00 ± 00 vs 27.46 ± 1.12; P < 0.001), resulting in a greater MMSE difference compared with the dexmedetomidine group (0.30 ± 0.94 vs -2.5 ± 1.12; P < 0.001). Pre- and postoperative S100B levels showed no significant difference in the two groups.
Conclusions: Dexmedetomidine, as a hypotensive agent, is more effective in maintaining cognitive function based on MMSE scores and shows no significant difference from remifentanil in S100B level parameters.
Abbreviations: FESS: Functional endoscopic sinus surgery, MMSE: Mini-Mental State Examination, POCD: postoperative cognitive dysfunction
Keywords: FESS, Dexmedetomidine, Remifentanil, MMSE, S100B
Citation: Warnoatmodjo MA, Harahap MS, Pramadika T. Dexmedetomidine can reduce cognitive disorders after FESS: a quasi-experimental, randomized trial. Anaesth. Pain Intensive Care 2025;29(9):1249-54. DOI: 10.35975/apic.v29i9.3044.
Received: May 06, 2025; Revised: August 04, 2025; Accepted: August 15, 2025
