Research Interests:
Background: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Intra operative bleeding leads to poor visibility of surgical field, and is of major concern during... more
Background: Functional endoscopic sinus surgery (FESS) is a minimally invasive technique that is used to treat chronic sinusitis. Intra operative bleeding leads to poor visibility of surgical field, and is of major concern during functional endoscopic sinus surgery (FESS). Controlled hypotension (lowering the mean arterial blood pressure to between 50 and 65 mmHg in normotensive patients) using a variety of pharmacological agents during general anesthesia reduces blood loss and helps clear visibility of the surgical field. The aim of this study was to compare surgical conditions for FESS during controlled hypotension provided by nitroglycerine (NTG) or magnesium sulphate (MGS) under general anesthesia.
Patients and methods: 50 adult patients of both sexes requiring FESS under general anesthesia were randomly divided to receive either nitroglycerine infusion of 3- 5 μg/kg/min (group NTG, n = 25) or magnesium sulphate (group MGS, n = 25) 30 mg/kg, administered as a slow i.v. bolus and 10mg/kg/h by continuous infusion during the operation, to provide controlled hypotension. In both groups mean arterial blood pressure (MABP) was reduced until the targeted MABP (55-65 mmHg) was achieved.
Results: Both drugs produced the desired hypotension, in the magnesium group there were better operative conditions, reduction in the duration of surgery and reduced anesthetic requirements. However there were longer extubation and emergence times in comparison with nitroglycerin group. Heart rate values were significantly higher in NTG group compared to magnesium sulphate group.
Conclusion: Both nitroglycerine and magnesium sulphate can be used safely to provide controlled hypotension during FESS. However magnesium sulphate was better as it provided optimum surgical condition and less tachycardia. In addition, it led to decreased anesthetic requirements.
Patients and methods: 50 adult patients of both sexes requiring FESS under general anesthesia were randomly divided to receive either nitroglycerine infusion of 3- 5 μg/kg/min (group NTG, n = 25) or magnesium sulphate (group MGS, n = 25) 30 mg/kg, administered as a slow i.v. bolus and 10mg/kg/h by continuous infusion during the operation, to provide controlled hypotension. In both groups mean arterial blood pressure (MABP) was reduced until the targeted MABP (55-65 mmHg) was achieved.
Results: Both drugs produced the desired hypotension, in the magnesium group there were better operative conditions, reduction in the duration of surgery and reduced anesthetic requirements. However there were longer extubation and emergence times in comparison with nitroglycerin group. Heart rate values were significantly higher in NTG group compared to magnesium sulphate group.
Conclusion: Both nitroglycerine and magnesium sulphate can be used safely to provide controlled hypotension during FESS. However magnesium sulphate was better as it provided optimum surgical condition and less tachycardia. In addition, it led to decreased anesthetic requirements.