Deliberate hypotension in ENT surgery

Condon, H. A.

doi:10.1111/j.1365-2273.1979.tb01896.x

Cited by 6 publications

(3 citation statements)

References 19 publications

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“…However, simultaneous use of them in some cases is not without risk and can cause a variety of cardiac arrhythmias such as ventricular fibrillation. [3]…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation between two methods of induced hypotension with infusion of Remifentanil and Labetalol during sinus endoscopy

2016

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Objective:This study aimed to compare two methods of controlled hypotension using labetalol and remifentanil in terms of capability to create controlled hypotension and to investigate the obtained complications, and satisfaction rate of surgeon and patient during functional endoscopic sinus surgery.Methods:In this prospective clinical trial, 62 patients underwent endoscopic sinus surgery in Al-Zahra and Ayatollah Kashani Hospitals of Isfahan were divided into two groups: in the first group, 20 mg bolus dose of labetalol and then infusion of it, at a rate of 0.5–2.0 mg/min and in the second group, remifentanil with dose of 0.5–1 μg/kg started and then 0.25–0.5 μg/kg/min were prescribed. Hemodynamic parameters during anesthesia and recovery time, surgeon and patient satisfaction, and recovery time were measured and recorded.Findings:Hemodynamics variable were comparable between two groups at different times of the study. The mean of bleeding and the frequency of side effects were higher in labetalol group (P = 0.033 and P < 0.0001, respectively). The median of surgeon satisfaction score in remifentanil group was statistically higher in labetalol group (P < 0.0001). Recovery time, fluid requirement, and pain score in labetalol group reported significantly more than remifentanil group. Richmond Agitation–Sedation Scale status at time points in the postanesthetic care unit showed differences between groups.Conclusion:With infusion of labetalol and remifentanil after a bolus dose we can induce effective controlled hypotension under general anesthesia. Remifentanil is a short-acting narcotic drug; then, patient satisfaction was better and recovery time was shorter. From the economic aspect, labetalol prefers to remifentanil.

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“…However, simultaneous use of them in some cases is not without risk and can cause a variety of cardiac arrhythmias such as ventricular fibrillation. [3]…”

Section: Introductionmentioning

confidence: 99%

Comparative evaluation between two methods of induced hypotension with infusion of Remifentanil and Labetalol during sinus endoscopy

2016

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“…Abgesehen von den oft fehlenden Voraussetzungen einer blanden Anamnese für den Gefäßstatus, den arteriellen Blutdruck, den Komplikationen scheint zwar erstaunlich gering zu sein, jedoch belegen die wenigen veröffentlichten Fälle wie z. B. des postoperativen Auftretens einer Tetraplegie die Gefahr der kontrollierten Hypotension [6]. Auch experimentelle Arbeiten liefern eindeutige Hinweise auf potenzielle Organschäden infolge kontrollierter Hypotension [7].…”

Section: Risiken Der Kontrollierten Hypotensionunclassified

Moderne Anästhesieverfahren in der endonasalen Nasennebenhöhlenchirurgie

Rathjen¹,

Bockmühl²,

Greim³

2006

Laryngorhinootologie

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“…70 Proposed benefits include 1) reduced intraoperative blood loss, 2) improved surgical visualization, 3) shortened operative time, and 4) decreased use of and exposure to blood products. 43 The efficacy and safety of this technique have been studied in general plastic surgery, 18,19,23,36,43,72 neurosurgery, 1,3,24,25,28,31,47,48,57,62,74 maxillofacial surgery, 4,7,16,20,21,38,51,54,59,60,73 orthopedic surgery, 2,6,17,35,41,44,46,52,53,67,69 general surgery, 15,33,65 otolaryngology, 8,29,55,56,61,71 bur...…”

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confidence: 99%

Controlled hypotension and blood loss during frontoorbital advancement

Seruya

Oh²,

Rogers³

et al. 2012

PED

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Object Controlled hypotension is routinely used during open repair of craniosynostosis to decrease blood loss, although this benefit is unproven. In this study the authors analyzed the longitudinal relationships between intraoperative mean arterial pressure (MAP) and calculated blood loss (CBL) during frontoorbital advancement (FOA) for craniosynostosis. Methods The authors reviewed the records of infants with craniosynostosis who had undergone primary FOA between 1997 and 2009. Anesthesia records provided preoperative and serial intraoperative MAP. Interval measures of CBL had been determined during the course of the operation. The longitudinal relationships between MAPmean, MAPchange, and CBLchange were assessed over the same time interval and compared between adjacent time intervals to determine the directionality of associations. Results Ninety infants (44 males and 46 females) underwent FOA at a mean age and weight of 10.7 ± 12.9 months and 9.0 ± 7.0 kg, respectively. The average intraoperative MAP was 56.1 ± 4.8 mm Hg, 22.6 ± 12.1% lower than preoperative baseline. A negative correlation was found between CBLchange and MAPmean over the same interval (r = −0.31, p < 0.05), and an inverse relationship was noted between CBLchange of the previous interval and MAPchange of the next interval (r = −0.07, p < 0.05). Finally, there was no significant association between MAPchange of the previous interval and CBLchange of the next interval. Conclusions Calculated blood loss demonstrated a negative correlation with MAP during FOA. Directionality testing indicated that MAP did not affect intraoperative blood loss; instead, blood loss drove changes in MAP. Overall, these findings challenge the benefit of controlled hypotension during open craniofacial repair.

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Deliberate hypotension in ENT surgery

Cited by 6 publications

References 19 publications

Comparative evaluation between two methods of induced hypotension with infusion of Remifentanil and Labetalol during sinus endoscopy

Comparative evaluation between two methods of induced hypotension with infusion of Remifentanil and Labetalol during sinus endoscopy

Moderne Anästhesieverfahren in der endonasalen Nasennebenhöhlenchirurgie

Controlled hypotension and blood loss during frontoorbital advancement

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