| Functinal endoscopic sinus surgery (FESS) is a common treatment for chronic sinusitis, nasal polyps, and other sinus-related conditions. While nost patients have a positive experience with FESS, post-operative pair is a common issue that can be difficult to manage. Opioids are routinely used to manage post-operative pain but are associated with various side effects, including nausea, vomiting, drowsiness, and respiratory depression. Preventative analgesia is a pain management method that reduces pain and opioid consumption following surgery. The use of nalbuphine and dexmedetomidine for preventive analgesia in FESS has been gaining increasing attention in recent years.FESS is mostly performed under general anesthesia; post-operative pain management is critical to patient care. Preventive analgesia is a technique that involves administering analgesics before the onset of pain to prevent or reduce the severity of post-operative pain. Two drugs commonly used for preventive analgesia in FESS are nalbuphine and dexmedetomidine.Nalbuphine is a synthetic opioid agonist-antagonist that has been shown to provide adequate analgesia with a lower incidence of side effects compared to other opioids. Nalbuphine acts on mu and kappa opioid receptors to produce analgesia but also has antagonist activity at the mu receptor, which reduces the risk of respiratory depression and opioid-induced hyperalgesia Dexmedetomidine is a selective alpha-2 adrenergic receptor agonist that produces sedation, analgesia, and anxiolysis. Dexmedetomidine has been shown to reduce post-operative pain and opioid consumption in various surgical procedures.Nalbuphine is an opioid agonist-antagonist with a mixed agonist and antagonist effect on the mu, kappa, and delta opioid receptors. This leads to a lower risk of respiratory depression and opioid-induced hyperalgesia.On the other hand, dexmedetomidine is a selective alpha-2 adrenergic receptor agonist that provides sedative analgesic, and anxiolytic effects without causing significant hemodynamic consequences. These drugs have been used together in several studies to assess their effectiveness in giving preventive analgesia for FESS.Despite the increasing attention to using nalbuphine and dexmedetomidine for preventive analgesia in FESS, there is still a research gap in determining the optimal dosage and administration technique for these medications. Additional research is necessary to determine the most effective and safe preventive analgesia strategy for reducing post-operative pain and opioid consumption in FESS patients. |