الفهرس 
ANATOMIC CONSIDERATIONS IN RHINOPLASTY FUNCTIONAL ANATOMYOnly 14 pages are availabe for public view
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Abstract
Controlled hypotension is used and performed in operations that require a bloodless field to facilitate surgeon’s vision. This may be important since a small amount of blood may interfere greatly with the surgeon’s vision during the surgery, for example during rhinoplasty surgery.
The objective of this study is to compare the effect of opioid-free using Dexmedetomidine and opioid-based using Fentanyl on hemodynamics (inducing deliberate hypotension and providing a better surgical field exposure) , post-operative pain intensity and the incidence of side effects in patients scheduled for rhinoplasty surgeries.
Opioids are widely used for perioperative analgesia. However, the intra-operative use of large bolus doses or continous infusions of potent opioids may be associated with post-operative hyperalgesia and increased analgesic consumption.
The use of opioid-free analgesic technique have the propensity to decrease and even avoid many of these side effects and lead to early oral intake, early ambulation, earlier hospital discharge, and lesser readmission rates to the hospital in the post-operative period.
Dexmedetomidine is a highly selective Alpha-2 adrenoceptor agonist that provides sedation, analgesia, and sympatholysis.Perioperative intra-venous dexmed-etomidine administration is associated with a reduction in post-operative pain intensity, analgesic consumption and nausea.
Fifty adult patients undergoing rhinoplasty surgery were included. Patients were randomly divided into two equal groups. group D received Dexmedetomidine and group F received Fentanyl. Patients are ASA physical status I, age group ranged from 18 to 45 years.
We found that dexmedetomidine is better than fentanyl for patients who undergo rhinoplasty surgeries to achieve controlled hypotension , decrease dosages of postoperative analgesics, prolong the duration of postoperative analgesia and decrease postoperative nausea and vomiting.