Effects of preoperative oral beta blocker versus intraoperative nitroprusside or esmolol on quality of surgical field during tympanoplasty

Amr, Yasser Mohamed; Amin, Sabry Mohamed

doi:10.1016/j.jclinane.2011.02.007

Cited by 10 publications

(4 citation statements)

References 20 publications

(21 reference statements)

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“…To our knowledge, this is the first trial using oral labetalol for preoperative preparation whenever deliberate hypotension is required. However, the obtained results supported that previously documented, regarding the use of oral 13-blockers for preoperative preparation, by Apipan & Rummasak (35) Amr & Amin (36' 37) and Kim et al (38) who reported that premedication with oral propranolol (35), oral atenolol (36,37) or oral enalapril (38) before hypotensive anesthesia effectively allowed heart rate reduction with decreased amount of blood loss that allowed better quality of surgical field and reduction of amount of blood transfusion.…”

Section: Discussionsupporting

confidence: 89%

Labetalol Hypotensive Anesthetic Protocol paves the way to Safe Open Abdominal Myomectomy: Comparative study versus Tourniquet Hemostasis

Ragab

Hagras

Salem

et al. 2018

The Egypt. J. of Fert.y of Steri.

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Section: Discussionsupporting

confidence: 89%

Labetalol Hypotensive Anesthetic Protocol paves the way to Safe Open Abdominal Myomectomy: Comparative study versus Tourniquet Hemostasis

Ragab

Hagras

Salem

et al. 2018

The Egypt. J. of Fert.y of Steri.

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“…The quality of surgical field assessed every 30 minutes using 5 point surgical area bleeding score given by Dolman et al [6,7]. The surgical area bleeding score was obtained from same surgical team who performed surgery in all patients.…”

Section: Methodsmentioning

confidence: 99%

The efficacy of intravenous clonidine premedication to reduce surgical area bleeding in posterior lumbar spine fusion surgery

2016

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Background: A posterior lumbar spine fusion surgery always associated with significant amount of blood loss and requires blood transfusion. The purpose of this study is to evaluate the efficacy of intravenous clonidine premedication to achieve bloodless surgical field and decrease the need for blood transfusion by controlled hypotension. Methods: Sixty patients scheduled for posterior lumbar fusion surgery were included in this randomized placebo controlled trail. Patients were classified into two groups: Group 1 received intravenous clonidine 3 µg/kg by infusion over 15 minutes before surgery and Group 2 received placebo as same. Hemodynamic variables, quality of surgical field by bleeding severity score, estimated amount of blood loss, duration of surgery and any blood transfusion were analyzed. Results: Heart rate and mean arterial pressure found less in clonidine group than placebo but not significant. The estimated blood loss (390.8±99.99 mL vs 741.13±79.90 mL; P = 0.001*) and duration of surgery (160.67±16.91 vs 205.9±16.72 min, P=0.001*) were significantly less in clonidine group compared to placebo. The quality of surgical field was better in clonidine group than placebo at all times. No cases of severe bradycardia or clinically significant hypotension were observed in clonidine group. Conclusion: Premedication with intravenous clonidine 3 µg/kg found clinically safe & effective drug in controlling blood loss and improves quality of surgical field in posterior lumbar fusion surgeries as a sole agent.

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“…but labetalol achieved control significantly more often with the starting dose and had fewer side effects. In support of the use of oral β-blockers for preoperative preparation whenever deliberate hypotension is required, Apipan & Rummasak [17], Amr & Amin [18,19] and Kim et al [20] reported that premedication with oral propranolol, oral atenolol or oral enalapril before hypotensive anesthesia effectively reduced heart rate, amount of blood loss, and blood transfused with better quality of surgical field.…”

Section: Journal Of Anesthesia and Intensive Care Medicinementioning

confidence: 99%

Untitled

2017

JAICM

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Objectives: Evaluating effect of oral labetalol pre-medication followed by low-dose intraoperative (IO) labetalol infusion on IO heart rate (HR) and mean arterial pressure (MAP), blood loss and need for transfusion and urine output (UOP) of patients undergoing open abdominal myomectomy.Patient & methods: Eighty-eight patients were randomly divided into: Study patients received 200 mg oral labetalol 2-hr before surgery and IO labetalol infusion (0.2mg/kg/hr) till completion of myomectomy. Control patients received placebo infusion and all patients received the same anesthetic protocol.Results: Operative blood loss and transfusion needs were significantly lower, but UOP was significantly higher in study than control patients. Oral labetalol significantly decreased preoperative HR and MAP of study patients compared to their baseline measures and to control patients. Oral labetalol significantly decreased HR and MAP elevations after induction and intubation compared to control patients. Labetolol infusion significantly decreased HR and MAP till stoppage of infusion compared to other measures and to control patients. Labetalol infusion allowed stability of HR and MAP with non-significant difference between measures till stoppage of infusion. Extubation significantly elevated HR and MAP in control patients, but non-significantly in study patients. Postoperative (PO), HR and MAP were significantly lower in study patients compared to baseline measures and to PO measures in control patients. PO hemoglobin concentration was significantly lower in all patients than preoperative concentrations, but concentration deficit was significantly lower in study than control patients. Conclusion:The applied protocol of labetalol hypotensive anesthesia improved anesthetic and surgical outcome of myomectomy.

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Effects of preoperative oral beta blocker versus intraoperative nitroprusside or esmolol on quality of surgical field during tympanoplasty

Cited by 10 publications

References 20 publications

Labetalol Hypotensive Anesthetic Protocol paves the way to Safe Open Abdominal Myomectomy: Comparative study versus Tourniquet Hemostasis

Labetalol Hypotensive Anesthetic Protocol paves the way to Safe Open Abdominal Myomectomy: Comparative study versus Tourniquet Hemostasis

The efficacy of intravenous clonidine premedication to reduce surgical area bleeding in posterior lumbar spine fusion surgery

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