a comparison of dexmedetomidine and magnesium sulfate as an anesthetic adjuvant in trans-sphenoidal pituitary surgery

Background: trans-sphenoidal pituitary surgery is a minimally invasive procedure used for pituitary disorders.objectives: this study aims to investigate the effects of dexmedetomidine and magnesium sulfate in improving anaesthesia conditions and pain control during trans-sphenoidal pituitary surgery. methods: this prospective randomised clinical trial included 90 patients between 18 and 65 years of age, with american society of anaesthesiologists (asa) physical status i and ii, who were undergoing elective trans-sphenoidal pituitary surgery. exclusion criteria included a change in surgical technique during surgery and patients who were transferred directly to the icu with a tracheal tube. patients were randomly assigned to three groups (group d: dexmedetomidine, group m: magnesium sulfate, and group c: control), and various parameters such as haemodynamics, surgical field evaluation, and pain were assessed. results: ninety consecutive patients were included in this study. forty-seven males (52.2%) and 43 females (47.8%) were evaluated. there were no significant differences among the three groups regarding gender distribution, age, or body mass index (bmi). the mean age of the included patients was 46.27 ± 12.47 years. the measured mean arterial pressure was lower in group d compared to group m (p-value = 0.005). the other variable that statistically differed between the two groups was the numerical rating scale, which was lower in group d (p-value = 0.02). all measured variables in group d and group m were significantly lower compared to the control group, except for the extubation time.conclusions: adding dexmedetomidine as an adjuvant anaesthetic medication during trans-sphenoidal pituitary surgery could potentially enhance haemodynamic stability and improve surgeon satisfaction scores.