ORIGINAL ARTICLE
Year : 2017  |  Volume : 10  |  Issue : 1  |  Page : 91-96

Controlled hypotension for functional endoscopic sinus surgery: a Comparative study between magnesium sulfate and nitroglycerin


1 Department of Anesthesia, Ain-Shams University, Cairo, Egypt
2 Department of Anesthesia and Intensive Care, Mansoura University, Mansoura, Egypt

Correspondence Address:
Randa Ali Shoukry
Department of Anesthesia, Ain-Shams University, 8 Ismail Ghanim St., AlNozha, Cairo, 1184
Egypt
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/asja.asja_46_16

Rights and Permissions

Background Intraoperative bleeding during functional endoscopic sinus surgery (FESS) leads to poor visibility of the surgical field, and is of major concern. Controlled hypotension, using a variety of pharmacological agents, during general anesthesia reduces blood loss and helps clear visibility of the surgical field during FESS. The aim of this study was to compare the surgical conditions for FESS during controlled hypotension provided by nitroglycerin (NTG) versus magnesium sulfate (MGS) under general anesthesia. Patients and methods Fifty adult patients of both sexes requiring FESS under general anesthesia were randomly divided to receive either NTG infusion of 3–5 µg/kg/min (group NTG, n=25) or MGS (group MGS, n=25) 30 mg/kg, administered as a slow intravenous bolus and 10 mg/kg/h by continuous infusion during the operation, to provide controlled hypotension. In both the groups, the mean arterial blood pressure was reduced until the targeted mean arterial blood pressure (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 (85.3±13.1 vs. 92.9±10.3 min) and reduced anesthetic requirements [average end-tidal sevoflurane concentration (vol %) and fentanyl consumption (μg); P<0.0001]. However, there was longer extubation time (10.0±2.9 vs. 5.5±2.3 min) and recovery time (16.7±4.4 vs. 9.8±2.3 min) in comparison with the NTG group. Heart rate values were significantly higher in the NTG group compared with the magnesium group (P<0.0004). Conclusion Both NTG and MGS can be used safely to provide controlled hypotension during FESS. However, MGS was better as it provided optimum surgical condition and less tachycardia. In addition, it led to decreased anesthetic requirements.


[FULL TEXT] [PDF]*
Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)
 

 Article Access Statistics
    Viewed214    
    Printed1    
    Emailed0    
    PDF Downloaded35    
    Comments [Add]    

Recommend this journal