Effets de l'isoflurane sur le saignement en microchirurgie de l'oreille moyenne

Clonidine decreases intraoperative bleeding in middle ear microsurgery

“…In our study, endotracheal intubation was associated with significant increases in SBP (14%), DBP (16.5%), and heart rate (16.4%) as compared with baseline values in the control group, whereas changes in the clonidine group were not observed. On the other hand, an increase in the risk for postoperative hypotension and bradycardia reported with the use of clonidine (2, 4, 5, 17) was not found in our series. Side effects were similar in both study groups, including dryness of mouth.…”

“…Controlled hypotension is used for reducing bleeding as an aid to surgery in patients undergoing middle ear or nasal surgery, neurosurgical operations, major orthopedic procedures, head and neck surgery, and different procedures in plastic surgery (1–3). Although the approach is multifactorial, the principal mechanism employed is reduction of the vascular tone.…”

“…Clonidine, a potent suppressor of sympathoadrenal activity, has been given orally before operation to augment the hypotensive action of isoflurane (2). In the open, controlled, randomized study of Woodcock et al (3), single dose oral premedication with clonidine 0.6 mg in patients undergoing middle ear or nasal surgery significantly reduced the vapor requirement for isoflurane‐induced hypotension, although it did not entirely obviate the need for further supplementary agents to facilitate induced hypotension.…”

“…D ELIBERATE lowering of blood pressure is used as an aid to surgery (e.g., during middle ear surgery) to produce a bloodless surgical field (1, 2). Isoflurane is a popular agent for inducing hypotension because it is simple to use and has favorable effects on the systemic and cerebral circulations.…”