Rhinorrhea due to Infusion of Dexmedetomidine during Rhinoplasty: A Case Report and Current Literature Review


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Yanaral T. U., KARAASLAN P., GÜNGÖR H., ATALAY Y. O., Tobias J. D.

Haseki Tip Bulteni, vol.60, no.3, pp.281-283, 2022 (ESCI) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 60 Issue: 3
  • Publication Date: 2022
  • Doi Number: 10.4274/haseki.galenos.2022.8389
  • Journal Name: Haseki Tip Bulteni
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, CINAHL, EMBASE, Directory of Open Access Journals, TR DİZİN (ULAKBİM)
  • Page Numbers: pp.281-283
  • Keywords: Controlled hypotension, dexmedetomidine, rhinoplasty, rhinorrhea
  • Istanbul Medipol University Affiliated: Yes

Abstract

Dexmedetomidine can be used to achieve controlled hypotension during surgery. A 26-year-old female with no medical history underwent rhinoplasty. The maintenance of the anesthesia was achieved with propofol and dexmedetomidine (1 mcg kg-1 as a loading dose for 10 minutes, followed by 0.5 mcg kg-1 hr-1 as maintenance) infusion as total intravenous anesthesia. Propofol and dexmedetomidine infusion doses were adjusted to maintain a bispectral index of 40-60 and a mean arterial pressure of 55-65 mmHg. During surgery, rhinorrhea developed, which disrupted the view of the surgical field. An intravenous antihistamine and a topical decongestant were administered. However, rhinorrhea persisted, suggesting that it developed as a drug-related adverse effect. Dexmedetomidine was halted. Subsequently, the rhinorrhea decreased, and the quality of the surgical field improved. That was a temporary and reversible side effect, which resulted in no long-term sequela. To the best of our knowledge, this is the first patient who developed rhinorrhea as a side effect of dexmedetomidine infusion during rhinoplasty.