Comparison of Labetalol, Nitroglycerine and High Dose Propofol for Induced Hypotension in Functional Endoscopic Sinus Surgery in Massive Nasal Polyposis: A Randomized Trial

  • Seyed Mohammad Mireskandari ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Jalil Makarem ORCID Mail Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Babak Saedi ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Afshin Jafarzadeh ORCID Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Kasra Karvandian ORCID Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Negar Eftekhar ORCID Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Shahram Samadi ORCID Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Hossein Majedi ORCID Department of Anesthesia and Intensive Care, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran.
  • Amin Amali ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Roja Toosi ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Batool Naghavi ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
  • Fardis Vosoughi ORCID Otorhinolaryngology Research Center, Tehran University of Medical Sciences, Tehran, Iran.
Keywords:
Functional endoscopic sinus surgery, Induced hypotension, Labetalol, Nitroglycerine, Propofol

Abstract

Background: The aim of this study was to assess the quality of the surgical field, amount of blood loss, and duration of surgery following induced hypotension with labetalol, nitroglycerin, and high dose propofol in patients undergoing FESS under general anesthesia.
Methods: One hundred and eight patients scheduled for FESS under general anesthesia were recruited in this randomized trial and were allocated to one of the three study groups: 1) Nitroglycerine (NTG) group: nitroglycerine with a dose of 2-5 μg/kg/min was administered; 2) Labetalol (LAB) group: an IV bolus dose of labetalol (20 mg) was injected at first and then IV infusion of labetalol at a rate of 1-2 mg/min; 3) High dose propofol plus normal saline (0.5-1 ml/min) group. Hemodynamic variables and the amount of bleeding were recorded intraoperatively and the surgeons' satisfaction was asked following each surgery considering the surgical field quality using a 5-item Likert scale.
Results: The average blood loss (ml) in patients in the LAB group was significantly less than patients in NTG and high dose propofol groups (127 ml vs 198 and 145 ml, respectively) (p- value=0.001) and the surgeons expressed greater satisfaction with the surgical field quality in the LAB group (p- value=0.001).
Conclusion: Labetalol infusion may be a safe and effective method for induction of controlled hypotension to provide a comparatively bloodless field. High dose propofol may be a second choice if labetalol is not available.

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Published
2020-08-18
How to Cite
1.
Mireskandari SM, Makarem J, Saedi B, Jafarzadeh A, Karvandian K, Eftekhar N, Samadi S, Majedi H, Amali A, Toosi R, Naghavi B, Vosoughi F. Comparison of Labetalol, Nitroglycerine and High Dose Propofol for Induced Hypotension in Functional Endoscopic Sinus Surgery in Massive Nasal Polyposis: A Randomized Trial. Arch Anesth & Crit Care. 6(3):112-7.
Section
Research Article(s)