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The efficacy of Labetalol versus Nitroglycerin for induction of controlled hypotension during sinus endoscopic surgery. A prospective, double-blind and randomized study.
J Clin Anesth. 2017 Jun; 39:154-158.JC

Abstract

OBJECTIVE

To assess the efficacy of labetalol versus nitroglycerin for induction of controlled hypotension during sinus endoscopic surgery.

DESIGN

A prospective, double-blind and randomized study.

SETTING

Carried out in operating room in university hospital.

PATIENTS

60 patients of both sexes, American Society of Anesthesiologists (ASA) physical status I and II, age range from 20 to 60years; scheduled for elective sinus endoscopic surgery under general anesthesia (GA).

INTERVENTIONS

Patients were divided into two groups (30 each). NTG group received nitroglycerin infusion at a dose of 2-5μg/kg/min, LAB group received labetalol infusion at a dose of 0.5-2mg/min.

MEASUREMENTS

Surgical condition was assessed by surgeon using average category scale (ACS) of 0-5, a value of 2-3 being ideal. In both groups mean arterial blood pressure (MAP) was gradually reduced till the ideal ACS for assessment of surgical condition, the target of ACS was 2-3 or lower.

RESULTS

Both studied drugs achieved desired hypotension and improved visualization of surgical field by decreasing bleeding in the surgical site, but ideal surgical conditions were created at mild hypotension (MAP 70-75) in LAB group while same conditions were created at MAP of 65-69mmHg in NTG group. Mean heart rate (HR) was significantly higher in NTG group as compared to LAB group. Blood loss decreased significantly in LAB group.

CONCLUSION

Both labetalol and NTG are effective and safe drugs for induction of controlled hypotension during sinus endoscopic surgery. While, labetalol was better as it offered optimum operative condition with mild decrease in blood pressure, decreased surgical bleeding and less tachycardia during the surgery.

Authors+Show Affiliations

Department of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University, Egypt.Department of Anesthesia & Surgical ICU, Faculty of Medicine, Tanta University, Egypt.Department of ENT, Faculty of Medicine, Tanta University, Egypt. Electronic address: ahmed.younes@med.tanta.edu.eg.

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial

Language

eng

PubMed ID

28494895

Citation

El-Shmaa, Nagat S., et al. "The Efficacy of Labetalol Versus Nitroglycerin for Induction of Controlled Hypotension During Sinus Endoscopic Surgery. a Prospective, Double-blind and Randomized Study." Journal of Clinical Anesthesia, vol. 39, 2017, pp. 154-158.
El-Shmaa NS, Ezz HAA, Younes A. The efficacy of Labetalol versus Nitroglycerin for induction of controlled hypotension during sinus endoscopic surgery. A prospective, double-blind and randomized study. J Clin Anesth. 2017;39:154-158.
El-Shmaa, N. S., Ezz, H. A. A., & Younes, A. (2017). The efficacy of Labetalol versus Nitroglycerin for induction of controlled hypotension during sinus endoscopic surgery. A prospective, double-blind and randomized study. Journal of Clinical Anesthesia, 39, 154-158. https://doi.org/10.1016/j.jclinane.2017.03.003
El-Shmaa NS, Ezz HAA, Younes A. The Efficacy of Labetalol Versus Nitroglycerin for Induction of Controlled Hypotension During Sinus Endoscopic Surgery. a Prospective, Double-blind and Randomized Study. J Clin Anesth. 2017;39:154-158. PubMed PMID: 28494895.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The efficacy of Labetalol versus Nitroglycerin for induction of controlled hypotension during sinus endoscopic surgery. A prospective, double-blind and randomized study. AU - El-Shmaa,Nagat S, AU - Ezz,Hoda Alsaid Ahmed, AU - Younes,Ahmed, Y1 - 2017/04/10/ PY - 2016/06/21/received PY - 2017/02/24/revised PY - 2017/03/04/accepted PY - 2017/5/13/entrez PY - 2017/5/13/pubmed PY - 2018/3/2/medline KW - Controlled hypotension KW - Labetalol KW - Nitroglycerin KW - Sinus endoscopic surgery SP - 154 EP - 158 JF - Journal of clinical anesthesia JO - J Clin Anesth VL - 39 N2 - OBJECTIVE: To assess the efficacy of labetalol versus nitroglycerin for induction of controlled hypotension during sinus endoscopic surgery. DESIGN: A prospective, double-blind and randomized study. SETTING: Carried out in operating room in university hospital. PATIENTS: 60 patients of both sexes, American Society of Anesthesiologists (ASA) physical status I and II, age range from 20 to 60years; scheduled for elective sinus endoscopic surgery under general anesthesia (GA). INTERVENTIONS: Patients were divided into two groups (30 each). NTG group received nitroglycerin infusion at a dose of 2-5μg/kg/min, LAB group received labetalol infusion at a dose of 0.5-2mg/min. MEASUREMENTS: Surgical condition was assessed by surgeon using average category scale (ACS) of 0-5, a value of 2-3 being ideal. In both groups mean arterial blood pressure (MAP) was gradually reduced till the ideal ACS for assessment of surgical condition, the target of ACS was 2-3 or lower. RESULTS: Both studied drugs achieved desired hypotension and improved visualization of surgical field by decreasing bleeding in the surgical site, but ideal surgical conditions were created at mild hypotension (MAP 70-75) in LAB group while same conditions were created at MAP of 65-69mmHg in NTG group. Mean heart rate (HR) was significantly higher in NTG group as compared to LAB group. Blood loss decreased significantly in LAB group. CONCLUSION: Both labetalol and NTG are effective and safe drugs for induction of controlled hypotension during sinus endoscopic surgery. While, labetalol was better as it offered optimum operative condition with mild decrease in blood pressure, decreased surgical bleeding and less tachycardia during the surgery. SN - 1873-4529 UR - https://www.unboundmedicine.com/medline/citation/28494895/The_efficacy_of_Labetalol_versus_Nitroglycerin_for_induction_of_controlled_hypotension_during_sinus_endoscopic_surgery__A_prospective_double_blind_and_randomized_study_ DB - PRIME DP - Unbound Medicine ER -